mi'bBUMH ACADEMY OF MEl
322 North Craig St,
Pi7i GH, PA,5

Sectio7v,of Male Pelvis'.

THE

IN HEALTH AND DISEASE, .

FROM INFANCY TO OLD AGE.

BEING A COMPLETE PRACTICAL TREATISE ON THE

ANATOMY AND PHYSIOLOGY

OF THE MALE SYSTEM;

WITH A DESCRIPTION OF THE CAUSES, SYMPTOMS, AND

TREATMENT, OF ALE THE INFIRMITIES AND

DISEASES TO WHICH IT IS LIABLE.

ADAPTED FOR

EVERY MAN'S OWN PRIVATE USE,

AND INCLUDING AN INTRODUCTORY ACCOUNT OF ALI

THE NEW DISCOVERIES CONCERNING THE

PHYSIOLOGY OF THE FEMALE SYSTEM AND

THE PROCESS OF REPRODUCTION.

By FREDERICK HOLLIOK, M. D.

OF "the origin of life," — "the diseases of woman,"-
"outlines of anatomy and physiology, for popular
use," — and "the matron's manual."

/

llustrated by numerous appropriate anatomical plates,
expressly designed for this work.

NEW YORK

PUBLISHED BY NAFIS & CORNISH,

ST. LOUIS, Mo: NAFIS, CORNISH & CO.
1850.

\r\

&

\

r^

\

Entered according to Act of Congress, in the year 1849,

By FREDERICK ROLLICK, M. D.,

in the Clerk's Office of the District Court of the United States for

the Southern District of New York.

Stereotyped "by "Vincent Dill, Jr.,
No. 21 Ann Street, N. T.

aiiw^oM^

rth Craig St.,
piT LGH, PA.

PREFACE

In the course of my practice, and more especially at the
termination of my Lectures to Gentlemen, I have been
repeatedly asked whether I could not refer them to some
book, that would give a plain and practical explanation of
the Male System, and its various derangements, adapted
for every man's own use and instruction ? In short a book
■was wanted that should serve the same purposes for
Gentlemen that my " Diseases of Woman" did for
Ladies ; explaining fully all those affections peculiar to
their own systems, and none others. No such work, how-
ever, was extant, and I saw that the only way to supply
what seemed a general want was to write one. It is true
there were works professing to treat on the Male System,
for popular use, but they were all, without exception,
principally devoted to Venereal diseases, and those who
made the enquiry of me were not persons at all liable to
such affections, nor feeling any particular interest in them.
My audience would frequently say, " We are not subjects
of syphilis, and probably never shall be, but still we are
liable to many other diseases, most of which could doubt-
less be prevented if we knew their nature and causes ; but
unfortunately for us, with the exception of your Lectures,
there is no source of information on such matters open to
us. We want a Book that will treat on these things in the
same style that your Lectures do, and it will be a public
service if you will write such a one." For a long time I

IV PREFACE.

was desirous of complying "with this request, but my time
was so incessantly occupied that I could not do so. The
materials I had in profusion, for I had consulted every
book on these subjects that was worth reading, both in the
English and other languages, and I had besides my own
notes of cases, as numerous and varied as perhaps any one
practitioner ever met with, but still all these materials
required arranging and writing out. I had besides to
make a number of direct experiments, with animals, and
of dissections of the human body, for the purpose of testing
the new discoveries on Generation, announced by the
European Physiologists, which were so utterly opposed to
old notions and doctrines. In addition to these causes of
delay, I had also several peculiar and highly instructive
cases in hand, the termination of which I was desirous to
see, so that I could make use of the novel experience they
gave.

Had it not been for all these causes combined I should
have published this book earlier. The delay, however, has
been necessary in order to have it complete, and I was
determined it should not be issued till it was so. It may
be advisable to state also, for the information of those not
acquainted with me or my previous publications, that my
course of study, and long practice, has been almost exclu-
sively devoted to the physiology and derangements of the
Reproductive System, in both sexes, respecting which I
have had unusual opportunities for obtaining information,
both in this country and in Europe. Whenever any new
discovery, or mode of treatment, has been announoed, I
have immediately tested it thoroughly, and have further
made every allowable experiment suggested to myself.

There are certain difficulties connected with the Repro-
ductive System that are very important, as affecting
human health and happiness, but which are scarcely ever
made the subjects of study by medical men at all, at least
not in this country. The consequence is, that the treat-

PREFACE. V

ment they receive is mostly empirical, and as liable to do
harm as good. So evident is this, that many persons so
afflicted never apply for medical assistance, but prefer to
suffer on and not complain. This is particularly the case
with many difficulties experienced by young persons, and
with many troubles incident to Marriage, such as
Impotence and Sterility, aversion or indifference, and
physical or moral unsuit ability . In the old world there
are men of the greatest eminence who devote their sole
attention to those matters, and who are the alleviators of
misery, and the dispensers of unexpected happiness to
thousands. In this country I am not aware of any one,
besides myself, that has embraced this peculiar line of
practice, and I have found the greatest want of information
prevailing, even amongst medical men, respecting the
means of relief that are really at our command: In all
probability many of the modes of practice, and many of
the resources, pointed out in this work, will be entirely
new to thousands, and will give hope to many who had
previously been sunk in despair.

As far as my professional duties would allow, I have
endeavored to instruct the public on those matters by my
Lectures, which have been attended by thousands of both
sexes, and which I intend to continue, as far as possible, in
various parts of the Union. These Lectures are devoted,
like the present work, to the Physiology of the Reproduc-
tive System, and to its derangements and diseases, except-
ing those of a Venereal character, which my audience
seldom enquire about. My Book on " The Diseases of
Woman" and my Lectures to them alone, treat on the
female system only. The present work, and my Lectures
to Gentlemen alone, treat on the male system only, so
that a source of interesting and useful study, and of prac-
tical advice, is open to both.

I am aware that such an attempt as the present will
appear strange to some, and may meet with slight objec-

VI PREFACE.

tion with the unreflecting and prejudiced ; but I feel
assured that any reasonable person, on due reflection, will
approve of it. That such afflictions as those I have
described do exist is unfortunately too true, and it there-
fore becomes the duty of every one, as far as lies in hia
power, to alleviate them. This I am persuaded can be
accomplished, to a great extent, by such information as
that I have here given, and I sincerely wish it may do as
much good as I intended and desire it to do.

In addition to every subject relating directly and exclu-
sively to the Male System, I have thought it necessary to
give a general description of the Female System also, and
of the process of Reproduction, in order to explain more
fully and clearly certain difficulties that could not be well
understood without such information. This description
will be found to include the most recent information on
these subjects, with several interesting discoveries of my
own, and will therefore supply every item of information
necessary to a full imderstanding of the Generative System
and its functions in both sexes. A great part of this infor-
mation cannot be found in any other work in the English
language, and is now for the first time laid before the
public.

Many parts of this book will be found as useful to
Medical men as others, because there are few of them that
are fully acquainted with the subjects on which it treats,
or who know where to seek for the requisite information.

F. HOLLICK, M. D.

New York.

CONTENTS.

< o «— ►»-»-

Page

DESCRIPTION OF FRONTISPIECE, \. 13

PART I.

REPRODUCTION, . . . .15

CHAPTER I.
The Female System, ... 21

CHAPTER II.
The Male System, .... 43

CHAPTER III.

The Semen, ..... 46

vm

CONTENTS.

PART II.

DISEASES, MALFORMATIONS AND DE-
RANGEMENTS OF THE MALE SYS-
TEM, . .

CHAPTER IV.

The Diseases, Deficiencies and Malforma-
tions of the Testes, their Envelops,
and the parts more immediately con-
nected with them,

Anomalies in the size and apparent number of the Testes.

Hydrocele, or Dropsy of the Testicles,

Sarcocele, or Chronic Fleshy Swelling of the Testicle,

Fungus of the Testicle, .

Hernia Humoralis, Orchitis, or Inflammation of the Testicles,

Ossification of the Testicle,

Arrest of Development and "Wasting of the Testes, .

Tubercular Disease, or Consumption of the Testicle,

Foreign Bodies in the Scrotum along with the Testicles,

Nervous Affections of the Testicles,

Spermatocele, or Swelling of the Testes from engorgment

of Semen, ......

Scrotocele or Rupture of the Intestines or Omentum into

the Scrotum, .....

Varicocele and Circocele, or Swelling of the Veins of the

Scrotum and Spermatic Cord,
Hsematocele, or Swelling of the Scrotum and Spermatic

Cord from the effusion of Blood,
Prurigo, or Itching of the Scrotum, . .

Elephantiasis Scroti, .....

Falling of the Spermatic Cord, ....
Relaxation of the Scrotum, ....

Diseases of the Vasa Deferentia, . • H~ •

Diseases of the Seminal Vesicles, . .

Page

63

69

73

79
94
98
100
109
110
117
119
ib.

126

127

130

134
135
137
139
140
141
147

CONTENTS. IX

Page

CHAPTER V.

The Structure, Diseases and Malforma-
tions of the Penis and the parts im-
mediately CONNECTED WITH IT, . 148

Absence and Malformation of the Penis, . . . . 152

Hypospadias, . . . . . . 156

Epispadias, ....... 160

Phymosis, ........ ib.

Paraph ymosis, ....... 161

Want of Development, or congenital small size of the Penis, 164

Paralysis of the Muscles of the Penis, .... 179

Priapism, or Involuntary Erection, .... ib.

Diseases of the Urethra and the parts contained therein, . 186
The Prostate Gland, . . . . . .191

CHAPTER VI.

Functional and Sympathetic Diseases of

the Genital Organs, . . ,197

Influence of the Brain on the Generative Powers, . . 200

Influence of the Mind over the Generative Organs, . . 207

Excessive Sensibility of the Genital Organs, . . . 216

CHAPTER VII.

Spermatorrhoea, or excessive loss of Semen, 219

Causes of Spermatorrhoea, ..... 226

Particular effects of Spermatorrhoea, . . . s 231

Symptoms by which the Spermatorrhoea may be detected, 264

Impotence from Involuntary Emission, . - . 270

Treatment of Spermatorrhoea, ..... 291

CHAPTER VIII.

The Influence of Medicines in Producing
and Curing Impotence and Sperma-
torrhea, .... 302

X CONTENTS.

Tage

CHAPTER IX.
Masturbation and other Sexual Abuses, 321

CHAPTER X.

Erotomania and satyriasis, . . .390

CHAPTER XI.

General Remarks on the Preservation

and Restoration of the Sexual Powers, 398

ILLUSTRATIONS. XI

ILLUSTRATIONS.

Page
PLATE I.

SECTION" OF FEMALE PELVIS, ... 19

PLATE II.

FRONT VIEW OF THE FEMALE PELVIS, . . 25

PLATE III.

OVARIES AND VESICLES, .... 31

PLATE IV.

UTERUS AND APPENDAGES LAID OPEN", . . 41

PLATE V.

SEMINAL ANIMALCULES, .... 49

PLATE VI.

XTTERITS AT FOUR MONTHS, ... 55

PLATE VII.

SECTION OF THE WOMB, NATURAL SIZE, . 61

PLATE VIII.

SEMINAL TUBES OF THE TESTICLE, . . 67

PLATE IX.

HYDROCELE, ..... 81

PLATE X.

SECTION OF PENIS AND BLADDER, . . 145

DESCRIPTION OF FRONTISPIECE.

Section of the Male Pelvis to show the situations of the
different parts.

A. The Bladder. — B. The Rectum, or end of the large
Intestine. — C. The lower part of the back bone, or
Sacrum. — d. d. The small Intestines. — -f. One of the Kid-
neys.— g. g. The Ureter, or Tube which conveys the
Urine from the Kidneys into the Bladder. — h. The Pubic
or Frontal Bone of the Pelvis.

1. The left Testicle.— 2. 2. The Vas Deferens, or Tube
which conveys the Semen from the Testicle. — 3. The left
Seminal Vesicle, with which the Vas Deferens is con-
nected.— 4. The Ejaculatory Canal, into which the Semen
next passes. — 5. The Prostate Gland, with which the
Ejaculatory Canal connects, and through which the Semen
passes into the Urethra, or Urinary passage from the
Bladder, (7). — 6. Is the Veru Montanum, or small protu-
berance which partly closes the neck of the Bladder. —
7. 7. The Urethra, or passage by which the Urine escapes
from the Bladder down the Penis. — 8. The upper part of
the Penis, or Corpus Cavernosum. — 9. The lower part, or
Corpus Spongiosum.— 10. The Glans, or head of the
Penis. — 11. One of Cowper's Glands.

The course of the Semen is from the Teste along the Vas
Deferens to the Seminal Vesicle, then along the Ejacula-
tory Canal and throtigh the Prostate Gland into the
Urethra, which it enters by the lower part of the Veru
Montanum, at the part indicated by the two black dots.
It then escapes from the body in the same way as the
Urine does.

PART I.

-4-^4— ► «»-*-

REPRODUCTION.

The Reproductive process in the human being,
as in all other perfectly organized animals, requires
the concurrent action of two different organizations,
the male and the female, each performing a distinct
part, one as necessary as the other. Neither of these
organizations alone can effect the whole process of
reproducing a new being, though in certain cases
they may 'partly do so, in an imperfect manner. To
understand fully the action of each, which is re-
quisite before their derangements and diseases can
be understood, . it is requisite to give a general
description of both, and also of Reproduction it-
self. This description can now be given with
something like accuracy, owing to the valuable dis-
coveries of modern science, and a correct idea can
be obtained, of the main steps at least, of this won-
derful phenomenon, though hitherto it has been
shrouded in such impenetrable mystery.

18

PLATE I.

Section, of the Female Pelvis.

A. The Bladder.

B. The Womb.

C. The Vagina.

D. The Rectum, or end of the large Intestine.
e. One of the Ovaries.

/. The Corresponding Fallopian Tube.

g. The Os Tincse, or Mouth of the "Womb, which opens

into the Vagina, or lower passage.
h. The Meatus Urinarius, or Mouth of the Bladder, by

which the Urine escapes.
i. i. The Small Intestines.

j. j. The Sacrum, or lower part of the back bone.
k. The Pubic, or Front Bone of the Pelvis.
I. The Right External Lip.
m. The Right Internal Lip, or Nympha.
n. The Hymen.

o. The Opening through the Hymen.
p. The Clitoris.
q. The Perineum.

9*

Plate I.

Section of Female Pelvis.

CHAPTER I.

THE FEMALE SYSTEM.

The office of the female system is twofold : it
has to produce in the first place one of the original
principles, or primary parts, from which the new
being begins ; and also to effect its development
into the perfect form. The female organs are
therefore much more complicated than those of the
male, and her part of the process is more extended.

The most essential parts of the female organiza-
tion are two organs termed the Ovaries, which are
located in the abdomen, one on each side, just
above the groin. These organs have the power,
when their full development is attained, to produce
certain little bodies called Ova, or Eggs, essen-
tially the same as the eggs of birds, one of which is
always required in the commencement of a new
being.

These organs are small in early life, and com-
paratively inactive, but at a certain period, termed
puberty, they become larger, and commence a
series of curious and important physiological pro-
cesses, the object of which is to develop the egg and
to effect its expulsion from the body.

When the ripe Ovaries are dissected they are
found to contain a number of cells, or vesicles,
which may be compared to those of a honey-comb,

22 THE FEMALE SYSTEM.

and in each of those cells is contained one of the
germs or eggs, surrounded by a white fluid like the
white of an egg. These cells are termed the
Graafian Vesicles, after the Anatomist Graaf, who
first described them • they are about as large,
when fully developed, as a small pea, but are not
all of the same size at once, some being small or
merely rudimentary, and others approaching per-
fection. Before the age of puberty these cells and
the eggs they contain, are all undeveloped and
small, but at that time their gradual and successive
development commences. It is found, from recent
observations, that only one of them is perfected at a
time, and that it requires a certain period before
another can be produced. In the adult ovary
therefore we find them at every stage, some being
only in the rudimentary state, others just com-
mencing to grow, and others having attained a con-
siderable size, there being always one more ripe
than any of the others, and evidently approaching
to perfection.

When the egg is fully developed it is thrown out
of the Ovary, and after a time makes its escape
from the body, in a very curious manner only
recently discovered. There are therefore two
different actions performed by the Ovaries, first
the forming or developing of the eggs in successive
order, and secondly, the expulsion of them from
the Ovary, and ultimately from the body.

This development of the eggs it must be remem-
bered is entirely independent of sexual union or ex-
citement, and is totally unconnected with conception,
except as a preparation for it. In every female,
whether virgin or not, from the age of puberty till
the turn of life in old age, this development of the

THE FEMALE SYSTEM. 23

eggs is always going on, excepting in certain dis-
eases, and during gestation and nursing, when it is
usually suspended. It is also performed in certain
definite and regular periods, which are nearly the
same in all persons alike. This period is usually
one month, or twenty-eight days, and most females
observe precisely that period with singular regu-
larity. During every month, therefore, after
puberty, with the exceptions above nanied, one of
the Graafian Vesicles, and its included egg, arrives
at perfection, and at the end of the month the egg is
expelled from the body.

The egg appears to be expelled from the Ovary
by a real inflammatory action, similar to what
nature establishes to effect the expulsion of an in-
jurious foreign substance in any other part of the
body. Towards the end of the month the Vesicle
begins to swell very much, and is filled with blood,
instead of the white fluid seen there at other times ;
the egg, which was formerly at the bottom of the
Vesicle, is now lifted up to the top, by the fluid
underneath, and is at last pressed forcibly against
the envelop or skin of the Vesicle. This pressure
becomes eventually so great that the envelop
bursts and the egg escaping through the rent
reaches the outside of the Ovary. It is then taken
to a particular part of the body to remain for a cer-
tain number of days, during which it may be im-
pregnated, or receive the male principle, and if this
takes place, they both remain and develop into the
new being, but if no impregnation is effected then,
at the end of that time the egg is passed out of the
body and lost. From this it is evident that impreg-
nation, or conception, can take place only during
those days after the egg is expelled from the Ovary,

24

PLATE II.

Front View of the Female Pelvis, with the External Walls
removed.

A. The Bladder.

B. The Womb.

D. The Rectum, or Large Intestine.

e. e. The Ovaries.

/. /. The Fallopian Tubes.

i. i. The Small Intestines.

r. r. The Round Ligaments.

This shows the situation of the Organs in the front of
the body, as they appear when it is first opened.

Plate II.

Front view of the Female Pelvis.

THE FEMALE SYSTEM. 27

and while it yet remains in the body, as will be ex-
plained more fully further on.

The inflammatory action by which the Vesicle
is filled with blood, and the egg expelled from the
Ovary, is not altogether confined to those parts, nor
to that one process, but affects other parts, and ac-
complishes other purposes. The whole Ovary,
and also the neighboring organs, become at that
time singularly excited and congested with blood,
and at last, to relieve themselves, the blood mixed
with mucus is discharged, -to subdue the inflamma-
tion. This discharge usually lasts about four
days, and is termed the Menstrual, or monthly flow.
This flow, therefore, about which so little has pre-
viously been known, is caused by the expulsion of
the Ovum or Egg from the Vesicle, and indicates
the period when that expulsion takes place. Con-
sequently in those who have no Ovaries, or in
whom they are torpid, or destroyed by disease, no
menstruation takes place. And for the same rea-
son it is not seen before puberty, because the eggs
are not then ripened, nor after the turn of life,
because then they are all expelled. This discharge
is therefore an indication of the capability for con-
ception, and it is also, in all probability, a means of
removing much injurious matter from the system,
so that female health is materially dependent upon
it, and those in whom it does not appear, or becomes
irregular, are nearly certain to become diseased. It
is proper to remark, however, that it is sometimes
nearly or quite colorless, and then the persons think
they have no. menstruation, though it may never-
theless be perfectly regular.

When the egg is fullj expelled it leaves behind
it the hollow Vesicle, filled with clotted blood, at

28 THE FEMALE SYSTEM. '

the top of which is a torn place, or rent, through
which the egg escaped. In a short time this blood
dries up and changes to a dull yellow color, while
the rent forms a scar on the surface of the Ovary,
and we thus have produced the yellow body called
a Corpus Luteum, which was formerly thought to
result from conception only, but is now known to be
an old Vesicle from which an Ovum has been ex-
pelled. On the surface of the Ovary of an adult
female a number of these scars are always to be
seen, but as they gradually fade away and disappear,
only some few, and sometimes only the last one, can
be distinctly seen. The Vesicles are contained at
first, in their rudimentary state, in the body of the
Ovary, and appear to develop in succession, the
outer ones first, each one when fully ripe projecting
on the surface like a small pimple or nipple till it
bursts. The egg itself, when fully developed, is
only about as large as the point of a pin, in fact it
can only just be seen by the naked eye. This may
appear singular when compared with the large egg
of a bird, but it must be recollected that the bird's
egg is surrounded by the nutritious matter from
which the new being is to be made, because it is
totally separated from all other sources of nutrition,
but the Human Ovum remains in the mother's body
and derives nourishment from her blood to effect its
development, it has therefore no need for any supply
of nourishment to be attached to it. The actual
germ is probably no larger in the bird than in the
human female.

When the egg is fully ripe, if it receives the male
principle, it will develop, to a certain extent, into
the human organization yi any part of the body.
But it cannot fully and perfectly develop except in

THE FEMALE SYSTEM. 29

a particular organ, called the Matrix, the Uterus, or
Womb. The position of this organ in the body may
be seen in the Plates. It is a small hollow organ in
its natural state with very thick walls, but capable
of undergoing astonishing changes, and possesses
every requisite both for the perfect development of
the new being, and also for its expulsion into the
world when fully grown.

The Ovaries are attached to the Uterus, one on
each side, by ligaments or bands, but have no direct
connection with its cavity. The connection between
the Ovaries and Womb is by means of two organs,
one attached to each side of the Womb just above
the Ovaries, called the Fallopian Tubes. A small
cavity leads from the inside of the Womb down
these Tubes to the end opposite the Ovaries, which
is expanded like a Trumpet, and surrounded by a
number of fringes or Tentaculee, like the fingers of
a hand.

The Womb is placed at the top of the passage or
Tube called the Vagina, and opens into it by a
small mouth called the Os Tincse, or mouth of the
Womb. The lower part of the Vagina opens ex-
ternally by the mouth called the Vulva. There is
therefore ajlirect passage from the Ovaries to the
outside of the body, by which the Ova or Eggs are
expelled.

After this description, the maturation and expul-
sion of the egg, and the process of conception can
be readily understood by the following 'explanation
and by referring to the Plates.

An egg becomes ripe at the end of every monthly
period in one or the other of the Ovaries, and when
expelled in the manner above described it is taken
into the Womb in the following manner : At the

3*

30

PLATE III.

Ovaries, Graafian Vesicles, and Ova

1. One of the Ovaries just before the Crisis. — a. Is the
Graafian Vesicle that is nearly ripe, and preparing to
burst, the Ovum projecting upon it like a small
pimple.

2. The same Ovary cut through, to show the Interior. —

a. Is the Vesicle as seen within ; the dark centre
denoting the clot of blood which throws out the Egg. —

b. Is an old Vesicle, from which an Egg has been ejected
at some former crisis. It is now drying up, and forms a
Corpus Luteum.

3. Is the Graafian Vesicle removed and magnified. — a. Is
the Ovum, or Egg, just breaking through the rent in
the Vesicle.

4. Is the Egg itself magnified, showing its granular struc-
ture.— a. Is the Germinal Vesicle.

Plate HI.

Ovaries and Vessicles.

THE FEMALE SYSTEM. 33

precise time when the egg is fairly loose from the
Vesicle, the expanded end of the Fallopian Tube
grasps the Ovary over the spot where it is, and the
fringes or fingers at the end of the Tube take hold
of and carry it into the passage. The Tube then
contracts and the egg is gradually forced down its
interior till it reaches the Womb.

When the egg arrives in the Womb it would of
course pass immediately out, by way of the Vagina,
if there were not some contrivance to prevent it,
which of course there is, and of a very simple and
perfect character. While the egg is passing down
the Tube there is formed in the interior of the
Womb a thin membrane, or skin, which lines its
walls and closes the passage at its mouth. While
the egg passes out at the Uterine end of the Tube it
presses on this membrane and makes a depression
or nest in which it lies.

As long therefore as this membrane remains
attached the egg is retained in the Womb, and con-
ception is possible, because the male principle can
penetrate through it without obstruction, but at the
end of a certain time the membrane looses away and
parts from the body, taking the egg along with it,
after which, of course, there can be no conception
till another such period comes round and another
egg is lodged there in the same manner. Conse-
sequently there is only a part of each month during
which conception can take place, and during the
rest of the month it is impossible / The precise
period during which conception can occur varies in
different persons, being in some only one or two days,
and in others much longer, but it probably never
extends beyond half the month, or fourteen days.
This statement I am aware will surprise many per-

34 THE FEMALE SYSTEM.

* sons, it being generally thought that conception may
take place at almost any time ; but there is no
question that this is an error.

As near as can be ascertained, the flow occurs
while the expulsion is taking place from the Ovary,
and the egg does not reach the womb until the first
or second day after the discharge has ceased, it is
therefore from the second day after the cessation of
the period that the time during which conception
can take place is reckoned. This time, I think it
necessary to state again, is so various in different
females that no general rule can be laid down, and
there are so many causes which make its com-
mencement and duration uncertain, that it cannot
be calculated upon practically, except by ex-
perienced persons. There are signs by which the
period during which conception is impossible can be
told in every female, with perhaps a few exceptions,
but they can only be detected by those who have
been long in the habit of observing them. The
Membrane and Egg together are so small, and so
delicate in their structure, that no female perhaps
ever observed them, though passing from her body
every month. I have, however, obtained them, and
have pointed them out to persons, by the aid of the
microscope.

A knowledge of the above mentioned facts en-
ables us to explain many cases of barrenness, the
causes of which were previously unknown. In some
females the Ovary has not power to perfect the egg,
and it is constantly expelled before its- development
is complete, and therefore is not capable of being
impregnated. In others the Womb does not form
the Membrane, so that the egg instead of being re-
tained in the Womb passes immediately out, and

THE FEMALE SYSTEM. 35

conception has no chance to occur. Some females
can only retain the egg a few hours, or perhaps for
a day, and if not impregnated during that short
time they cannot be so during the rest of the month.
The most probable time for conception is from the
first to the fifth day after the cessation of the men-
strual flow.

The actual process of conception is in itself very
simple, and may be explained in a few words. The
semen, or male principle, is deposited, during as-
sociation, in the Vagina, and from thence conveyed
upwards, through the Os Tincse, into the cavity of
the womb. If it reaches the upper part, and the
egg be there, conception may occur ; but there are
many causes operating both to prevent its transit
and also to destroy its power. The upward passage
of the semen is accomplished by a peculiar vital
power in itself, which will be explained when we
describe the male system. The place of union of
the two principles is therefore usually in the upper
part of the womb, or possibly also at the uterine end
of the Fallopian Tube.

Immediately after impregnation has been effected
the egg attaches itself permanently to the walls of
the womb and begins to develop into a human
being, the womb expanding to allow of its doing so.
When fully grown the walls oY the womb begin to
contract and eventually expel it from the body, by
way of the vagina. During its growth the nutri-
ment required is obtained, in some way not very
well understood, from the mother's blood, the com-
munication between the Fcetus and its parent being
of the most wonderful and mysterious character.
Instances have been known of the egg, after its im-
pregnation, being taken back again, by a reverse

36 THE FEMALE SYSTEM.

action of the Tube, to the outside of the womb, and
partly developing there ; such cases are called extra
uterine conceptions, and they are supposed to result
from fright or other sudden and powerful emotions.
The natural action of the Tube is such that it can
only convey anything from the Ovaries towards the
womb, but sudden and strong excitement of the
nervous system may, for a short time, reverse this
natural action, and if there should then be an im-
pregnated egg at the uterine end of the Tube it may
be brought to the outside, and thus produce an extra
uterine conception. These, however, are always
imperfect, and of course can never be horn. Some-
times they form into tumors which may be carried
for years, or even for life, but more frequently they
decay after a time and pass away by an abscess,
often with little injury or risk to the patient.

The old notion about one Ovary producing males
and the other females, is incorrect, either one pro-
ducing both sexes. It is also an error to suppose,
as some persons do, that sexual feeling is requisite
in the female for conception to take place. There
is no question whatever that it can occur in certain
cases, not only without sexual feeling, but also
during sleep, or in a state of perfect unconsciousness,
though it is not so likely to do so. This will be
better understood, however, after the male system
has been described, when it will be shown that it
may be even effected artificially, without any
intercourse of the sexes at all.

This explanation, it will be observed, establishes
a perfect correspondence between the action of the
reproductive system in the human female and in all
others, such as reason and analogy would lead us to
expect.

THE FEMALE SYSTEM. 37

The constant production of Ova, or Eggs, at
regular periods, as a part of the proper action of
the female system, independently of sexual union
or excitement, is what universally occurs. In
those animals that bring forth their young alive, it
is true, we do not ordinarily see them, unless they
are closely looked for, owing to their small size and
to their remaining within the body to develop
when impregnated. But in those who produce
their young externally, as birds for instance, the
eggs are larger and easily seen, and it is well
known that they are regularly produced without
any concurrence of the male bird. These eggs
so produced, however, are infecund, that is, they
cannot develop, because they have not the male
principle. This is what we have shown occurs in
the human female ; the eggs are regularly pro-
duced, but when not impregnated are thrown off
and lost.

The use of impregnation therefore ^s to vivify or
perfect the egg, and not to produce it as the old
theories supposed.

In like manner we see that in all animals a crisis
is produced when the eggs are ripened and cast off,
strictly analogous to the monthly crisis in the
human female. The period, however, varies very
much, though always constant in the same being.
Thus some animals produce their Ova only once in
two or three years, as the Lion and Elephant for
instance, while others do so every year, usually in
the spring, as the Deer and wild cattle for instance.
When this occurs there is a peculiar excitement
engendered in the system, called the Rut, or heat,
which is accompanied by a flow, and is strictly
analogous to the monthly crisis in the human being..

38 THE FEMALE SYSTEM.

It is of course only at that period when the eggs
are ripened that impregnation can he effected, as is
well known with domestic animals, who conceive
only in the season of rut, or heat, which usually
occurs in the spring. They will not admit the male
at any other time, because there is not the requisite
excitement to create the desire to do so ; but even
if they were there could be no conception, simply
because there is no egg to be impregnated. In the
the human being the ovarian development is
monthly, and therefore conception can occur at
almost any period of the year, though only at a
particular part of each month. In some domestic
animals, as Fowls and Rabbits for instance, the
ovarian development is almost incessant, so that
they produce eggs, or conceive almost without
intermission.

On dissecting the ovaries of any animal at the
proper period, all the appearances can be noted
that we have described in the human being. The
vesicles may be seen at various stages of develop-
ment, the Corpora Lutea may be detected where
ova have formerly been expelled, and, in birds, the
eggs themselves may be seen, some merely rudi-
mentary, others larger, and some nearly ready to
■be expelled. In the human being there is usually
but one vesicle, and its egg, ripened at each period,
but occasionally there are two or more, when we
may have twins, and so forth. So that in those
animals who have always several young at a birth,
there are, of course, always as many vesicles
ripened, and a Corpus Luteum is formed for each.

The structure of the egg is the same in all
animals, being precisely like that of the bird.
The main part is a mass of yellow granules, called

THE FEMALE SYSTEM. 39

the yelk, in which is found a small greenish
vesicle, called the germinal vesicle. The white por-
tion seen so large in birds, is, like the shell, an
accidental addition, and not strictly a part of the
ovum ; it is not needed in those Ova that are
developed in the body. In its passage down the
Tube the egg is broken open by the germinal
vesicle bursting through its outer envelop and
escaping. This breaking open of the egg is, as
will be shown when the male principle is described,
a necessary preparation for conception, and is in
itself a very curious phenomenon.

I am aware that the facts I have stated, and the
conclusions drawn from them, are totally at vari-
ance with many old theories and popular notions,
and will seem very strange to those who hear them
for the first time. It is, therefore, necessary for me
to state that they are not advanced without the
fullest authority. It is only very recently that a
knowledge of these curious and important facts has
been obtained, and they have not yet had time to find<
their way even into standard scientific works, in this
country, though well known to practical Physiolo-
gists. They are the results of actual experiment
and investigation, and are placed beyond the possi-
bility of doubt. These explanations have a very
different foundation, therefore, from the mere theories
and suppositions contained in most physiological
works, which are generally supported only by
questionable statements or loosely observed facts.

40

PLATE IV.

The Uterus and its appendages removed, to show their
connections.

B. TheWomo.

C. The Vagina.

e. e. The Ovaries.
/. /. The Fallopian Tubes.
g. The Neck of the Womb.
r. r. The Round Ligaments.
s. The Left Broad Ligament.

This view represents the Organs disconnected from all
the other parts. The passage of the Ovum, from the
Ovary down the Fallopian Tube to the Womb can be
readily understood by this plate.

Plate IV.

Uterus and appendages laid open.

43

CHAPTER II.

THE MALE SYSTEM.

The most essential organs in the male system
are two glandular bodies, called the Testes or Tes-
ticles, which are placed, after birth, outside of the
body, in an external envelop, called the scrotum,
hanging from the pubic bone. The use of these
organs is to produce the male principle, or semen,
as the ovaries produce the female ova or egg.
The Testes, like the Ovaries, are not capable of per-
forming their proper functions till a certain period
of life, called puberty, but unlike them, they are
not liable to lose their powers at any particular age,
but may preserve them indefinitely. In the early
stages of existence in the womb the testes are con-
tained in the abdomen, and only descend to the
scrotum just before birth.

On dissecting one of the testicles, it is found to
be chiefly composed of blood-vessels and numerous
small tubes containing semen. A branch of the
spermatic artery is sent from the abdomen down to
each testis, in which it divides and subdivides into
thousands of little branches, many of which are
too small to be seen by the naked eye. * It is this
artery that brings to the testes the pure blood from
which probably the semen is formed. The extreme
ends of the minute arterial branches are appa-
rently continous with the commencements of the
seminal tubes, so that in examining them we grad-
ually lose sight of the blood and begin to find

44 THE MALE SYSTEM.

semen. The seminal tubes are at first exceedingly-
minute, but very numerous, and they gradually
unite together to form larger branches, and trunks,
till eventually the whole form but one tube, called
the Vas Deferens, by which the semen is conveyed
to the Urethra. The number of these little tubes
has been estimated at over sixty thousand in one
testicle, and it has been shown, that, if they were put
in a straight line, they would measure many hun-
dreds, if not thousands of feet. There is also a
branch of the spermatic vein connected with each
testis, which ramifies in its substance similarly to
the artery. This vein is to take away the impure
and refuse blood when no longer needed.

The Testicles are therefore mainly composed of
three 'kinds of tubes, or vessels, namely, Arteries,
Veins, and Seminal Tubes. In addition to which
there are also numerous nerves, and Lymphatics, or
absorbents, the whole being connected together by a
cellular substance or tissue. Each one is connected
with the body by what is termed the spermatic cord,
which is a kind of sheath, or tube, about half an
inch in diameter, containing the main branches of
the Artery, Nerves, and Lymphatics, going to the
Testis, with the main branch of the vein, and the
Vas Deferens, coming from it. This spermatic
cord ascends into the Abdomen, when the different
vessels composing it are distributed to their res-
pective places. Each testis is also surrounded by
a distinct coat, or tunic, beside the scrotum, or outer
skin, in which both are enclosed.

The manner in which the semen is actually made
is of course unknown to us ; we can only point out
the place where it originates and explain its pro-
gress towards the exterior of the body.

THE MALE SYSTEM. 45

The Vas Deferens from each Testis, into which
all its seminal tubes have poured their contents,
ascends into the Abdomen through the spermatic
cord, and rises nearly as high as the top of the
bladder, behind which it turns, and then begins to
descend till it meets over its lower part with two
small organs called the Seminal Vesicles, with which
it becomes connected. From the seminal vesicles
the semen passes down a small tube called the
Ejaculatory Canal, which is attached to the bladder,
and which joins immediately under it, an organ
called the Prostate Gland. Finally, by means of
some curious openings through the prostate gland,
the seminal fluid is passed into the Urethra, or pas-
sage down the Penis, by which the urine escapes
from the bladder, and is thus ejected from the
body.

These several parts comprise the whole male
generative system, and in the act of impregnation
each one has a special function to perform. The
Testis secrete the semen, the Vas Deferens and
ejaculatory canal convey it to the Urethra, and the
penis deposits it in the Female Organs, while the
seminal vesicles and prostate gland either secrete
some necessary addition, or effect some modification
in it.

This general description will be sufficient for our
present purpose. A full account of each organ,
and of all their different diseases, will be given
further on. After the nature and properties of the
Seminal Fluid have been treated upon.

(A reference to the Frontispiece and its explana-
tion, will give a clear idea of the description here
given, and will also make any of the subsequent
articles be readily understood.)

46

CHAPTER III.

THE SEMEN.

The vivifying principle secreted by the male
testes is a yellowish white semi-fluid substance,
having a peculiar odor. It is slightly viscid and
of a saltish flavor, when fresh. On examination it
is found to consist of two distinct parts, one nearly
fluid and the other like globules of half-dissolved
starch, which, however, both melt together when it
is exposed some time to the air. The peculiar
odor of the Semen appears to be derived from some
of the parts through which it passes, for when taken
from the testes it has scarcely any smell at all.

Chemical analysis shows us that the semen dif-
fers but little in its composition from other sub-
stances found in the body. In 1000 parts there are
about 900 water ; 60 animal mucilage ; 10 soda ;
and 30 of phosphate of lime, with a peculiar animal
principle, the composition of which is unknown.
This analysis it must be recollected is that of the
semen, as it leaves the body, that is the secretion
of the Testes, Vesicles, Prostate Gland, and other*
parts, united together. How far the pure semen
from the testis alone differs from this is not known.
By some the starchy portion only is supposed to be
produced by the Testes.

The Seminal Animalcule. — The most curious
peculiarity of the semen, and in many respects the
most important, is that there always exists in it,
when perfect, a number of remarkable living

THE MALE SYSTEM. 47

beings, called the Zoospermes, or Seminal Animal-
cule. These beings were discovered many years
ago, but have not been accurately studied and
described till very recently. The representations
and descriptions given of them in old works are
mostly incorrect, and sometimes very extravagant,
and calculated to mislead rather than inform.
Some physiologists, who saw them imperfectly,
even doubted if they were living beings. The per-
fection of that magical instrument, the microscope,
however, and the patient investigation of such men
as Pouchet and his coadjutors have not only cor-
rected these old errors, but also disclosed to us new
truths, more wonderful even than the wild dreams
of former times.

As far as yet investigated these Animalcules exist
universally, in the Semen of all animals whatever,
but have a peculiar form and development in each.

It is also ascertained that they are developed
from a species of egg, or ovum, called the seminal
granules, or vesicles. Under the microscope a
number of these can always be detected, like little
globules of mucus, and they are observed to
undergo a regular series of changes similar to those
of the female ovary. When first observed they
are round and merely contain a number of small
granules, which are the Animalcules, in a rudimen-
tary state. At a further stage these granules are
found to be developed into small Animacules, while
the containing vesicles have expanded and become
elongated, or egg-shaped. Finally the vesicle breaks
open at one end, and the Animacules escape, being
at first very small and gradually growing after-
wards to the size we ordinarily see them.

The figures in the accompanying plate represent

48

PLATE V.

The Seminal AniriaalculEe in the Human Subject.

1. One of the Vesicles, containing the Animalcules in a
rudimentary state, coiled up.

2. The Vesicle broken open, and the Animalcules escaping.

3 and 4. Perfect Animalcules. — a. Is the stomach and in-
testines. The two round white spots at the top, indicate
the mouth and the sucker by which it attaches itself.
These are magnified many thousand times.

Plate V.

Seminal Animalcules.

THE MALE SYSTEM. 51

the form of the Zoospermes and the changes in
the vesicles, as seen under the microscope, in the
human being.

In different beins;s the form both of the Vesicle
and the Animaculee varies much, and occasionally
the Zoospermes undergo some remarkable meta-
morphoses before assuming their final form.

In the human being there are about thirty Zoo-
spermes in each vesicle, but in some beings there
are more, and in others not so many. The number
of vesicles varies very much, at different times,
even in the same individual.

The precise size of the Zoospermes is of course
difficult to ascertain, but Mr. Ruchet estimates
their length at about the ten thousandth 'part of an
ordinary hair, and their weight at about the hundred
and forty thousand millionth part of a grain !
A spot as large as a mustard seed, he remarks^
will sometimes contain fifty thousand of them, or
more.

Notwithstanding this extreme minuteness we are
now tolerably well acquainted with their peculiari-
ties of structure, and even with many of their habits ;
nor need this excite much surprise when it is recol-
lected that there are beings still smaller that have
been studied with even greater success. In Fig.
3 and 4 of the last plate, the form of the human
Zoospermes is given correctly, and their internal
organization is also partly shown by the part marked
a. a. Fig. 4, which is supposed to be the stomach.
In the perfect state each one has a sucker at the
larger end, represented by the white dot in Fig.
3 and 4, by which they can attach themselves to
any object. They are observed to change their
skins at certain periods, like snakes, and we some-

52 THE MALE SYSTEM.

times find the loose skin hanging about them in
shreds ; or cast off quite whole. In some animals
they have a number of hairs, or cilia, by the motion
of which they move in the fluid, and some even have
perfect fins. One Physiologist assures us that he
distinctly saw they were sexual, and that he could
readily distinguish the male and female ! They
are usually lively and active, with peculiar
motions, some of which are performed in concert
and others singly, with great perseverance and regu-
larity ; thus a number of them will sometimes form
into a ring, with their heads all one way, and run
round and round in a circle for a considerable
time ; or one may be seen by itself pushing before
it a large globule of mucus, or blood, many times
heavier than itself, for several minutes together.
One peculiarity is observable in all of them, and
that is an almost invariable tendency to move only
straight forward, and they will seldom turn to go
back even though they meet with an obstruction,
but often attach themselves to it by the sucker and
remain till they die. Very often they are seen to
enter into combats, and a number of them will fight
till only one is left alive. They will live for some
hours out of the body, particularly if put in warm
water, in which their motions may be readily seen.
The Zoospermes are not found before Puberty,
nor usually in extreme old age. Many diseases
also destroy them, and several drugs have the same
power. In all cases where they are absent or
destroyed, from whatever cause it may be, the
semen cannot impregnate, though in every other
respect it may be quite perfect, and the vigor of the
patient seem not in the least impaired. This has
been proved by filtering them away, and by destroy-

THE MALE SYSTEM. 53

ing them. The development of the Zoospermes it
will be observed is strictly analogous to that of the
ova or eggs in the females. Thus they are first
found in the form of little granules, enclosed in a
Vesicle which bursts as they become more perfect
and allows them to escape. In some animals there
is even a periodical development of them, similar to
that of the ova in the female, with which it usually
corresponds. In such animals the Testes are small
at other times, and increase in size at these periods,
because the Vesicles only attain their full, growth
then.

In tracing the semen from its source we find that
the annimalcules are not developed till it reaches
the Seminal Vesicles, and are sometimes not perfect
till it has reached the Prostate Gland. In the Tes-
ticles we never find the Zoospermes themselves, but
only the Vesicles containing the granules, which
gradually develop as it proceeds further on.

The Testes may therefore be compared to the
Ovaries, the Seminal Vesicles to the Graafian
Vesicles, and the Seminal Granules to the ova.
Some Physiologists consider the granules to be the
ova of the animalcules themselves, but this we can-
not yet decide, though it is certain the animalcules
originate from them.

The importance of these facts, in giving us a cor-
rect knowledge of the nature and proper treatment
of many diseases of these organs, will be seen as
we proceed, particularly when treating on Impo-
tence and Seminal losses.

The actual process of conception is also made
more clear from some of these details. For in-
stance the tendency which the Animalcules have to
move only straight forward, is in all probability the

5*

54

PLATE VI.

Section of the Uterus at four months of Pregnancy

a. a. a. The Thick Walls of the Womb.

b. b. The Foetus.

c. The Umbilical Cord.

d . d. The Placenta.

e. The Vitellus.

/. /. /. The Decidua.

g. The Chorion.

h. The Amnion.

i. i. Vessels of Placenta.

k. k. The inner openings of the Fallopian Tubes, which aro

here cut off.
I. The Mouth of the Womb, opening into the Vagina.
m. The Vagina.

Plate VI.

Uterus a.t four months.

THE MALE SYSTEM. 57

reason why they make their way up into the womb
from the vagina, and impregnate the egg. If it
were not for this tendency, combined with their great
motive power, the two principles could not be
brought together. Their power of living out of the
body for some time is also necessary to impregna-
tion, because they may not reach their destination
immediately. It is found that they will live in the
female organs, when these are healthy, as long as
twenty-six hours, and of course during any part of
that time conception may take place. Sometimes
conception may take place in a few minutes, and at
other times not till as many hours after the associa-
tion of the two sexes. It has been found on dissect-
ing an animal killed ten hours after connexion,
the semen had not even then reached the ovum,
though it usually passes into the womb almost im-
mediately.

It is evident from this how incorrect it is to
speak of the moment of conception as if it were a
period certainly known. No greater mistake could
be made than to suppose that it always corresponds
with the moment of connexion, because it may be as
much as twenty hours after, or more. It is also
evident from these facts why it is that conception is
possible loiihout actual connexion. If the semen is
merely deposited in the external lips it may impreg-
nate, because the animalcules may make their way
from thence up to the womb. It is also of little
consequence how the semen is deposited in the
female organs, providing it be perfect, and this
explains why it is that conception can be effected
artificially, by merely injecting the semen in the
female organs with a syringe, or otherwise, which
has often been done. The mere presence of the

58 THE MALE SYSTEM.

male organ is in no way essential ; which is the
reason why a certain mode of attempting to prevent
conception often fails. It was also remarked, in a
previous part, that sexual feeling in the female was
not necessary to conception, and this will now be
evident when it is recollected that the Animalculee
move up into the womb by their own vital power.
It is probable, however, that this feeling often con-
duces to conception, by establishing certain favor-
able conditions of the parts, and therefore that
event is not so likely to occur during sleep or un-
consciousness, though it is possible for it to do so.

The old idea that it was only the odor or aura of
the semen that ascended into the female organs and
impregnated the ovum, is too unfounded and ob-
viously incorrect to need refutation.

The presence or absence of the Zoospermes in
the Female Organs, and other parts, is the chief
evidence sought for in cases of alleged violation,
because in such cases they may certainly be found,
if the act has been committed, for as long as
twenty-six hours after alive, and dead for almost
any period if the fluids be dried.

It is now generally considered that the Animal-
cule is the true rudiment or germ of the future
human being, which is supposed to be developed
from it in the same way as the plant is developed
from the seed ; or rather the human being is
thought to be one of these Zoospermes developed to
a more perfect form by the power of the egg in
which it is placed. In proof of this we have the
fact, attested by several observers, that when the
egg breaks open, during its passage down the tube,
from the escape of the germinal vesicle, one of the
Animalculee, if then present, always creeps in. In

THE MALE SYSTEM. 59

fact it has been seen to do so, and we thus have a
probable explanation of the origin of human life,
if we suppose this minute being is the origin of the
future human being. If they are truly sexual we
may also have an explanation of the cause of the
difference in sex in ourselves, as this may be
dependent upon the sex of the Animalcules from
which we originate.

60

PLATE ViL

Section of the Uterus in the uninrpregnated state, and of
the Natural size.

a. a. Are its Thick Walls.

b. Is the Cavity in its upper part or body.

c. is the Cavity in the lower part, or Neck.

d. Is the Vagina.

e. e. The edges of the Walls of the Vagina, ctit through.

f. f. Two Threads, passing through the openings of the
Fallopian Tubes, and appearing in the inside.

g. Is the Mouth of the Womb, or Os Tincse opening into
the Vagina.

This view being of the full size, will give an idea of the
astonishing change this organ has to undergo in the pro-
cess of Gestation.

Plate VII.
Section of the Womb, natural size.

63

PART II.

DISEASES, MALFORMATIONS AND DERANGE-
MENTS OF THE MALE SYSTEM.

It is of the greatest importance that every man
should know sufficient of himself to be able to detect
the various derangements of his system at the
earliest possible moment, and that he should also
know the proper steps to take for their prevention
and removal. He who knows nothing of this kind,
and goes to a physician only when he feels pain or
inconvenience, will often find that he then cannot be
benefited, the favorable moment having gone by,
unknown to him through his ignorance. Some of
the most severe and dangerous diseases of the
Testes, for instance, cause neither pain nor incon-
venience till they are considerably advanced. I
shall therefore give all the indications, that can be
relied upon, of each disease, and also the treatment
to be pursued, making it in every case, as far as
possible, such as may be practised by the person
himself.

65

PLATE VIM.

Seminal Tubes of the Testicle, with: the Epididymis and

Vas Deferens.
a a. a. Lobules of the small Seminiferous Tubes, similar
to the Convolutions of the Brain.

b. The Rete Testis, a number of nearly straight Tubes into
which the smaller ones enter.

c. The Vasa efferentia, or larger Tubes, 12 or 18 in num-
ber, into which the semen passes from the Rete Testis.

d. Plexuses, or conglomerations of the Vasa efferentia,
which form a kind of head, almost like a small Testicle,
called the Epididymis.

e. e. The head of the Epididymis

f. f. The body of the Epididymis.

g. An appendix of the Epididymis, called the aberans.
It is not always met with.

h. The Tail, or Cauda of the Epididymis.
i. i. The Vas Deferens, which is at first very much
twisted, but becomes finally straight. '

From this view it will be seen that the small Seminal
Tubes gradually verge into the large straight ones, called
the Rete Testis, then into the still larger called the Vasa
efferentia, and finally they all coalesce into one Tube, the
Vas Deferens

Plate VIII.

Seminal Tubes of the Testicle.

69

CHAPTER IV.

THE DISEASES, DEFICIENCIES AND MALFORMA-
TIONS OF THE TESTES, THEIR ENVELOPS,
AND THE PARTS MORE IMMEDIATELY
CONNECTED WITH THEM.

As before remarked, the Testes are usually two
in number, the one on the left side being lower and
larger than that on the right. But sometimes
more than two appear to exist, and at other times
only one, or perhaps none. The arrangement of
one being higher than the other, when there are
two, prevents them from being crushed together
when the limbs are crossed, by allowing one to slide
over the other. The internal structure of them
having already been explained, it is only requisite
further to describe their envelops and attachments.

Immediately around each one is an envelop or
membrane, called the Tunica Albuginea or Peri-
testis, which surrounds every part, and also sends
branches, or leaves, into the substance of the Testi-
cle, so as to divide it to a certain depth, into lobes,
or sections, similar to the lobes of the brain, only
of a triangular shape.

The outside inclosure is called the Scrotum, or
purse, and is the same as the skin of the thighs. It
is divided vertically into two parts by a small
ridge, called the Raphcc, and is usually covered
with hairs at puberty. Underneath the Scrotum
we next find a reddish cellular membrane, called
the Dartos, which makes a separate sack for each of

70 DISEASES OF THE TESTES.

the two Testicles, which are separated from each
other by a vertical membrane placed between them,
called the Septum Scroti, which acts as a partition,
and thus the two organs are perfectly unconnected
with each other. The nature of the Dartos has
been a subject of dispute among anatomists, some
considering it to be merely a cellular tissue, and
others thinking it to be a muscle. It is undoubted-
ly partly muscular, and consists mainly of long
fibres, which cross and interlace each other in every
direction. It is the contraction of these fibres of
the Dartos that corrugates or wrinkles the Scro-
tum, as is well %seen when sudden cold is applied to
the external parts. Next under the Dartos comes a
true muscular coat, called the Crernaster Muscle,
or Tunica Erythoides, the use of which is to draw
the Testicle upwards. This is derived from one of
the muscles of the abdomen, and comes down
through the abdominal ring, forming part of the
sheath of the spermatic cord. The last coat is
called the Tunica Vaginalis, which is a true serous
membrane interlaced with blood-vessels, and comes
next to the Tunica Albuginea.

In a healthy state the muscular fibres of the
Scrotum are usually contracted, so as to draw the
skin into folds and brace the Testes up against the
Abdomen ; but during a state of debility, or from
great fatigue, they become relaxed, so that the testes
hang low, and pull upon the cord. It is an almost
certain sign of ill health when this relaxation of the
Scrotum occurs, at any period of life, and often
its removal is the first indication of improvement.
In old people, and in those of a bad habit of body,
this relaxed state becomes permanent.

By inspecting antique statuary, it will be seen

DISEASES OF THE TESTES. 71

that the ancients were practically acquainted with
this physiological fact, and they have accordingly
accurately represented it in their works of art.
The figures of all their men in health and vigor
have the Scrotum invariably drawn up to the abdo-
men, while those of old men, or sufferers, hang
pendant.

As a general rule the muscles of the scrotum are
independent of the will, or act involuntarily, but
instances have been known of men who could make
them act as they pleased. Some boys exhibit this
power before puberty, being able to draw the Testes
up to the abdominal ring, and let them fall again,
but it is seldom this command over them continues,
though one instance is on record. This man drew
the Testes up into the groin, so as to form apparent
ruptures, in order to escape being impressed into
the service. Being detected, however, he confessed
the trick, and made an exhibition of his extraordi-
nary power to the examining physicians. He
could pull up either one alone or both together, and
could also make one go up while the other was
coming down ; in short, he had the same command
over them as over his arms, and could rao^p them
as quickly. In another instance a man, who was
charged with being the father of an illegitimate
child, endeavored to evade the responsibility by
alleging he had no Testicles, and, therefore, could
not be the father, but it was discovered that he
could draw them up into the groin at pleasure. In
a healthy state the scrotal muscles are brought
powerfully into action during coition, so as to brace
the Testes tightly against the Pelvis, and one cause
of partial impotence in very weak or old people, is
the loss of this power, owing to which the semen is

72 DISEASES OF THE TESTES.

not expelled with sufficient force. In children this
relaxed or firm condition of these muscles is often a
valuable indication of the state of their health.

The form of the Testis is that of a somewhat
flattened oval, with one end a little larger than the
other. The average weight is about one ounce.

The Vas Deferens, or common Tube into which
all the small ones are emptied, commences at the
globus minor, or lower end of the epididymis, and
then passes into the spermatic cord by which it
enters the Abdomen, where its course has already
been traced. It is altogether about thirty-two feet
long- The sheath of the spermatic cord is com-
posed of two coats, the outer one of which is very
firm, like cartilage, so that the tube is not easily
compressed ; the inner coat is a mucous membrane,
similar to that inside the Urethra. This cord can
be readily felt externally.

This description of the Testes and their envelops,
combined with that before given, will be sufficient
to give a clear understanding of the various diseases
and derangements to which they are liable, and also.
of the reasons for the line of treatment laid down.
It will Ue seen that they are so placed, without the
body, as to have no direct connection with any
other organs, and they may, therefore, be removed,
without any other part being interfered with. This
operation, termed Castration, is sometimes necessary
in certain diseases, and sometimes it is the effect of
accident, or in some parts of the world of design.
The removal of the Testes, however, in whatever
way it may be effected, not only destroys the power
of procreation, but also interferes in a remarkable
manner with the growth and functions of various
other parts of the system, from which it is evident

DISEASES OF THE TESTES. 73

that they are necessary for the perfection of the
individual's own system, as well as for the purpose
of bringing new beings into existence.

ANOMALIES IN THE SIZE AND APPARENT NUMBER
OF THE TESTES.

The usual size of the Testes is about that of an
ordinary pigeon's egg, and their weight, as before
stated, is about one ounce. Occasionally, however,
they are seen much larger, and sometimes much
smaller, and their weight may be also considera-
bly greater or less than the average. I have
seen them as large as a full size hen's egg, yet per-
fectly healthy, and as small as marbles without
being in any way deficient in power. This is im-
portant to bear in mind in many cases that may
come under the physician's notice. I have known
men hesitate about marrying when the Testes were
very small, from fear that they would be deficient in
power, and it was with difficulty they could be con-
vinced to the contrary. In one instance of a young
man aged twenty-six, they were no larger than those
of a child of nine years old, yet his powers were
but little, if any, inferior to those of persons gene-
rally. After a great deal of hesitation, and much
persuasion, he married and became the father of a
large family. It is necessary to remark, however,,
that in these cases all the other organs were of
proper size, and that the smallness of the Testes had
existed from childhood, and was therefore a natural
state. If they had decreased in size, after having
been properly developed, it would have been very
different. The falling away or wasting of the
Testes, which follows many diseases, and sometimes

7

74 DISEASES OF THE TESTES.

takes place without any assignable cause, is usually
a serious matter, and is nearly certain to be followed
by a loss of power. The injudicious use of certain
drugs, particularly of Iodine, will frequently cause
the Testes to waste, and so will the exhalations
from some metals, as lead for instance, many work-
men in which I have known so affected. In giving
an opinion in such cases therefore, their previous
history must always be known, as well as the con-
dition of the other parts, and the physician will then
have but little difficulty in coming to a proper deci-
sion. Sometimes one only will be small, and the
other of average size, or one only may waste away,
without injuring the other.

An unusually large size of the Testes should
always excite suspicion of its being the result of
disease, and a most careful examination and inquiry
should therefore be made. If they have always
been of that size, or nearly so, from Puberty, and
especially if the other organs are large also, there
may be nothing to excite apprehension. The
symptoms of the different diseases hereafter de-
scribed should however be carefully studied, par-
ticularly those that cause enlargement, as Hydrocele
and Hernia Humoralis, for instance. I have
known the Testes of a youth of fourteen to be much
larger than those of most men, and yet perfectly
healthy ; such cases of unusual development are
not necessarily accompanied by extra power.

In some instances the development of all the
genital organs is very tardy, owing to the slow
growth of the Testes. I have seen a youth of nine-
teen that was in every respect in the' same state of
these parts, as when about seven years old. He
-was also but very little grown in other parts of the

DISEASES OF THE TESTES. 75

body, having the appearance of one about twelve
years old. In this case, there were perfect evi-
dences of sexual power, though slight, and all the
parts were evidently healthy. It was therefore a
case of torpid action,' or retarded development, and
I thought that in all probability nature could be
aroused. I accordingly gave him directions to use
stimulating lotions, with frictions and shampooing,
and to have a stimulating diet, with regular warm
bathing and plenty of out-door exercise. The effects
of this practice was soon evident ; in less than six
months an evident increase had taken place, both in
the size of the parts and in the intensity of the sexual
feeling. The external parts, which had previously
been perfectly bare and smooth, like those of a
child, became covered ; the voice assumed a more
manly tone, the muscles were more solid, the mind
more active, and manhood began to dawn. This
improvement continued going on till he was twenty-
one, when there was but little difference between
him and other young men of that age. If this case
had not been promptly and properly attended to, in
all probability no further development would ever
have taken place, and an early death would have
terminated his imperfect existence. To what age
an improvement of this kind is possible we cannot
of course tell, though I feel sure it may be effected
in older persons than is generally supposed, perhaps
till nearly thirty. The younger, of course, the
better. Several cases have been known of the
Testes growing after twenty-six years old.

Sometimes there appear to be Three Testicles,
and possibly in some of these cases there may really
be three, but more frequently one of the three
bodies is either the epididymis, somewhat enlarged,

76 DISEASES OF THE TESTES.

and much separated from the Testis, or else it is a
small tumor. Most^of those that have been observ-
ed in dissection have been small harmless tumors,
existing from birth. Three perfect Testicles, how-
ever, are occasionally found, but they are not
always accompanied by any unusual sexual power.

At other times there appears but one Testicle, or
perhaps none, and I have known young men in the
deepest distress from this cause. In some of these
instances there is really but one organ, as has been
proved after birth, and yet the individual has had
full average powers. It is more often the case,
however, that these deficiencies are apparent rather
than real. Before birth the Testes are contained in
the Abdomen, and they usually descend into the
Scrotum in the last month. It sometimes happens,
however, that the descent of one or both does not take
place, and the individual then appears so far defici-
ent. In these cases the power of the Testes is not
impaired by their unusual position, but perhaps is
often increased, and this has led uninformed persons
to think that men sometimes had procreative
powers without Testicles, because they could not be
found. A man once died in one of the London
Hospitals who had long been noted as having no
Testicles, and yet having all the usual powers. On
dissection two perfect ones were found in the Abdo-
men that had never come down, and thus the won-
der was solved. These cases, however, are but
rare. Dr. Marshall examined Ten Thousand eight
Hundred young recruits, among whom he found jive
in whom the right Testicle had not come down, and
six in whom the left had not ; there being but one
man in whom both were not descended.

It is much better for the Testes to remain totally

DISEASES OF THE TESTES. 77

in the Abdomen than to descend only to the groin,
as they sometimes do, because in the last position
they are apt to be compressed, by the other parts
crowding about them in the ring, and thus waste
away. The imperfect or non-descent of the
Testes must, however, always be considered an
imperfection, and though it may not cause incon-
venience, or loss of power, it is nevertheless
always to be feared. The Testis itself is as liable
to all its different diseases while in these unusual
positions as when in the Scrotum, and unfortunately
cannot then be reached. The neighboring parts also
become affected from it, and thus life may be lost
from a simple affection which could have been
completely removed, if the Testis had been in its
natural position.

In some instances the retained Testes descend
late in life, and if they then become fast in the
ring great swelling and severe inflammation may
result, with ultimate wasting away of the organs.
Such cases have been mistaken for ruptures, and
some men, from want of information, have thought
that the Testicles really growed at that time, all at
once.

When there are really no Testicle from birth,
there is always an imperfect development of the
whole system, and a total absence of sexual power
or feeling.

In some animals it is natural for the Testes
never to descend, but always to remain in the Ab-
domen, and in others they descend only at certain
seasons, that is, when they attain their periodical
development, owing to the full growth of the ani-
malcules.

It is stated, on the authority of several travellers,

•7*

78 DISEASES OF THE TESTES.

that there is a tribe of Hottentots at the Cape of
Good Hope that never have but one Testicle ; but
many naturalists think that more likely it is a cus-
tom among them to remove one in youth. It is
quite possible, however, that this deficiency may be
natural, and it is not in any way more singular
than many peculiarities observed in the genital
organs of the females of those tribes. I have known
two brothers, twins, one of whom had three Testes
and the other but one.

In some instances the two Testes have been found
grown together, so as apparently to form but one,
owing to absence of the usual septum.

The Testicles are sometimes drawn so close up
against the abdomen, owing to a contraction of the
cremaster muscle, that they cannot be discovered
without close examination, and are then often
thought to be absent, though they are quite perfect,
and even outside of the body. Medical men have
even testified that there were no Testicles, in such
cases as these, which shows the necessity for a
close and thorough examination of such apparent
monstrosities.

This state of things is not dangerous in itself, but
had better be removed if possible, because the Testes
are likely to adhere to the neighboring parts and
waste away, so as to cause perfect impotence. A
surgical operation is necessary to liberate them,
which is both difficult and somewhat dangerous.
In some few dissections the Testes have been found
completely absent, and without any trace of their
having existed. Sometimes the Vas Deferens ex-
ists by itself, and sometimes with the Epididymis,
though at other times there are no traces of either.
These cases of total congenital absence are, . how.

DISEASES OF THE TESTES. 79

ever, very rare, and are always indicated by defi-
ciencies in other parts of the system.

In some rare instances the Testes have descend-
ed into the Perineum, instead of the Scrotum, but
most probably from some imperfection in the parts
about the Perineum and Scrotum.

In the course of my practice I have been con-
sulted in many of these cases of Testicular anoma-
lies, and have often had the pleasure of removing
unfounded apprehensions, and of giving happiness
and confidence to those who had previously been
the victims of hopeless despair.

HYDROCELE, OR DROPSY OF THE TESTICLES.

This is sometimes called a swelled or watery
Testicle. Properly speaking, this is but seldom an
affection of the Testicles themselves, but of the
Scrotum in which they are contained. There are
three kinds of Hydrocele ; first, that in which the
fluid collects in the substance or tissue of the Scro-
tum ; secondly, that in which it is secreted by one
of the coats of the Scrotum ; and thirdly, that
in which it collects in the spermatic cord.

First Variety of Hydrocele. — This is scien-
tifically called Hydrocele (Edematodes, and it is
usually connected with general dropsy, or arises
from the treatment of some of the other varieties.
It is, however, but seldom met with, and rarely
arises of itself. In some cases it has been brought
on by wearing an improperly-constructed truss, by
blows, or even by tight clothing, but much more
frequently .it is only a consequence of some other

80

PLATE IX.

A case of Hydrocele laid open.

Fig. 1. a. The Penis much contracted. — b. The Scrotum. —
c. The Testicle. — d. The Vas Deferens. — e. The cut
edges of the Scrotum and the different coats. — -f. The
Tunica Vaginalis, which it will be seen is double, from
being reflected over the Testicle, which is on the outside

. of it. — g. Is the water, which is between the two folds
of the Tunic. — h. The Spermatic cord.

Fig. 2. External appearance of the Hydrocele, showing
the Veins also in a case of Varicocele.— 1. The dis-
tended Vein.

FIG. I.

Plate IX.

Hydrocele.

DISEASES OF THE TESTES. 83

disease, particularly dropsy of the abdomen, which
is likely to extend to the Scrotum. In this form of
disease the Testicle is usually softish at first, and
when pressed the mark of the finger remains of a
white color for some time after. As it progresses,
however, the Scrotum becomes harder, and perfect-
ly smooth, the Penis enlarges, particularly at the
prepuce, and in very bad cases the skin inflames
and sloughs away.

The treatment of this form of Hydrocele must
vary somewhat according to the conditions under
which we find it. If it results from general dropsy
it can be cured only by the removal of that, and
will require but little local treatment. If there be
any injurious pressure it must be immediately
taken away, and frequently the doing so will effect
an immediate improvement without anything further
being done.

The local treatment, after attending to the above
directions, must consist of frequent bathing with
cold alum water, one ounce to a pint, or of simple
cold water. A suspensory bandage must also be
worn constantly, except when the patient can
remain perfectly still, without standing too long.
The bowels must be kept free, and but little fluid
drunk. The following mixture may be taken for
four days, and then omitted four days, and so on
alternately till it has been taken twelve days in all,
unless the swelling is obviously going down after
the first four days, which it will often do, in which
case it need not be continued. R. Hydriodate
of Potassa, thirty-six grains, Distilled water, one
ounce. Dose, ten drops, morning and night, in
half a tumbler of water.

84 DISEASES OF THE TESTES.

Second Variety of Hydrocele. — This is usually
called Hydrocele of the Tunica Vaginalis, the fluid
being secreted by the inner coat of the Testicle,
and, therefore, contained in the cavity of the Scro-
tum. The swelling is observed on one side only,
in most cases, like a smooth egg or pear-shaped
tumor, of a natural color. It begins at the bottom
of the Scrotum, and gradually progresses upwards,
until it sometimes reaches the top and presses
against the abdomen. It is quite soft to the touch
at first, -and the fluid may be distinctly felt to fluc-
tuate or shift its position as the tumor is moved.
As the disease progresses, however, it becomes
harder, and does not fluctuate, and in form it
becomes more decidedly oblong.

From the above description, it will be seen that
this form of Hydrocele is easily distinguished from
that previously described, because in this the swell-
ing is observed on one side, and commences at the
bottom, while in the other it is diffused more or less
over the whole Scrotum at once, and is evidently in
the skin, or cellular tissue. Sometimes, it is true,
both halves of the Scrotum may begin to fill up
with fluid, but even then each one is sufficiently
distinct from the other for both to be distinguished,
and for the nature of the affection to be readily
seen.

A very good way to examine a Hydrocele is to
place a candle behind it and look in front, when
it will usually appear semi-transparent, and some-
times so perfectly so that the Testicle may be dis-
tinctly seen in the middle of the water, like the yelk
of an egg in the midst of the white. When the
Testicle cannot be seen in this way, it is often dif-
ficult to find it, and its position can only be ascer-

DISEASES OF THE TESTES. 85

tained by a hardish feeling in the back part of the
swelling near the top.

The quantity of fluid secreted in some of these
cases is very great, as much as six quarts having
been removed by Mr. Cline, from Gibbon the great
Historian. There may, however, be but a small
portion, and it may remain for many years, or even
during a person's life, without increasing, though
the probability is against this, and in some cases it
increases very rapidly.

It is singular also that even in some very bad
cases there is but little distress, and, except from
the inconvenience of its weight and size, many
patients suffer but little annoyance from it.
Sometimes, however, it causes an annoying sense
of uneasiness and pressure in the Testes and groin,
and occasionally even produces numbness of the
limbs. When very large the Penis is drawn into
the swelling, so that it appears smaller, and its
erection becomes difficult and painful ; the sperma-
tic cord is also pulled down, and becomes tender,
and the motion of the limbs is much interfered
with.

There is not much to be feared from a Hydrocele
of this kind, if the general health be good, unless it
be complicated with a real swelling of the Testicle,
the case then becomes very difficult, and nothing
can be done till the Testicle itself is cured. I
have known a man of sixty years of age who had a
Hydrocele from the time he was fourteen ; it was
of a considerable size, but had never much in-
commoded him, nor in any way interfered with his
health or functions. The difference in the symp-
toms of a Hydrocele and a swelled Testicle will be
pointed out in the article on Sarcocele.

8

86 DISEASES OF THE TESTES.

The causes of this form of Hydrocele are but little
known. It is undoubtedly brought about in some
cases by injuries, such as blows, pressure upon the
saddle in horse-riding, and by badly made trusses.
Too much standing will also dispose to it, par-
ticularly in those with a relaxed state of the muscles.
In general, however, it results from some constitu-
tional tendency, the nature of which is unknown,
4and which cannot be ascertained before the effect is
produced. In most instances, its beginning is
altogether unknown to the patient, and it progresses
so slowly and insiduously, that an advanced stage
may be reached before anything wrong is suspect-
ed. I have known young men suppose it was.
merely a natural increased growth of the parts.

The Treatment. — In the early stages it is some-
times sufficient to use cold lotions two or three times
a day, as prescribed for the first variety, particular-
ly that of alum. Frequent cold bathing, in addi-
tion, will assist, and, if the bowels be kept free and
but little fluid be drunk, the Hydrocele will occa-
sionally go down considerably, or even disappear
altogether. I would advise any one to continue this
simple treatment even if it only arrested the disease,
for though it might not positively cure, at first, still,
if it keeps matters from becoming worse, nature her-
self may work a cure in time. A suspensory band-
age should be worn form the very first, and as much
rest should be taken as circumstances will allow.
After using the simple alum-wash for some time, if
the swelling still continues, the following lotion may
be applied instead, night and morning.

R. Powdered Peruvian Bark, one ounce ; boiling
water, one pint. Boil these for ten minutes and then
add, when cold, half a pint of spirits of Camphor.

DISEASES OF THE TESTES. 87

This is, perhaps, the best lotion that ever was
used for this purpose, and has done more good than
all others put together. The parts should be bathed
with it for about ten minutes before the suspensory
bandage is put on in the morning, and for the same
time after it is removed at night.

In some cases the following wash has been found
to succeed even where the other did not.

R. Sugar of Lead, one ounce ; Laudanum, a
tea-spoonful ; Water, one pint.

This is to be used as a lotion, the same as the
other, and both must be applied cold.

Very little can be done by internal medication,
except to keep the bowels free, though occasionally
the following recipe may assist.

H. Vinegar of Colchicum ; Vinegar of Squills ;
and Nitric Ether, of each half a?i ounce — to be
mixed. Of this mixture a tea-spoonful may be
taken in a drink of water, three or four times a
day. Frequent' bathing, and clothing the body
warmly are also beneficial.

When all these means fail, however, as they too
often do, some kind of operation must be resorted
to, either to give temporary relief or with a view to
cure. It is customary, for the first purpose, to
puncture the sac of the Scrotum with a sharp
instrument and let out the water. If nothing more
be done than simply letting out the fluid, it will
usually fill again, though occasionally it does not.
To effect a perfect cure the Scrotum is injected
through the same wound, after the. fluid has all
escaped, with some astringent solution. Cold water
only is used by some practitioners, but more fre-
quently a mixture of two parts port wine to one of
water. Solutions of Iodine, and of Hydriodate of

88 DISEASES OF THE TESTES.

Potassa have also been used, and in some cases the
same fluid that was discharged, but the port wine
and water appear to act the best of any.

The manner in which this injection appears to
effect the cure is this ; it excites a considerable
degree of inflammation in the Testicle, and also in
the coats of the Tunics, so that they grow together,
and in this way the cavity in which the water accu-
mulated is entirely obliterated.

In most cases, if properly performed, this opera-
tion is quite successful, causes but little pain, and
is perfectly free from danger. In some instances,
however, it is unsuccessful, owing to the fluid not
being well injected, and occasionally there is much
more inflammation caused by it than what is desi-
rable, attended by serious constitutional irritation.
The puncturing instrument, and the tube to convey
the fluid, must be very carefully introduced, so as
not to injure the Testicle, but they must also be
carried sufficiently far to ensure all the water being
discharged. The proper place to make the punc-
ture is nearly at the bottom of the Tumor, behind ;
the fluid may remain in about five minutes, and
about as much must be injected as was drawn out.

Sometimes a difficulty occurs in this way ; after
the fluid has escaped the Tunica Vaginalis draws
together, so that the opening into it does not corres-
pond with the opening outside, and if the instrument
has become displaced, before the injection is thrown
in, it is difficult again to introduce it. In fact, it is
better, if this . occurs, to leave off* till another day,
and operate again, for the attempt, if too often
made, may cause serious and useless inflammation.
There is also danger, if the instrument is put in
again, that it may not go into the cavity, but merely

DISEASES OF THE TESTES. 89

into the substance of the skin, and the fluid is then
thrown into the cellular tissue, and not only does no
good, but may even remain, and produce a real
dropsy of the Scrotum, or Hydrocele CEdematodes,
the same as described under the head of the first
variety.

In fact, some Surgeons purposely perform the
operation in such a way as to change the Hy-
drocele into a simple dropsy of the Scrotum, by
letting the fluid into the cellular tissue, by simply
introducing a needle. The new disease is certainly
more easily cured than the former one, and the
pressure of the water on the Scrotum often prevents
any more being secreted in the Tunic, but still in
many cases a cure is not effected, and sometimes is
made more difficult. [ would much rather advise
the total discharge and injection.

This operation is very simple and successful in
skilful hands, but often fails from want of skill or
proper care. If too much inflammation follows,
poultices must be applied and other simple means
used to subdue it, and the patient must keep still.
It must be borne in mind, however, that con-
siderable inflammation is necessary, to effect a cure.
I once knew a man who operated upon himself
with a common penknife and a small catheter. He
effectually discharged all the water, but knew
nothing about injecting anything in return. At the
end of two years there was but little accumulated
again, and he thought so little of what he had done,
that he said he should always repeat the operation
himself, as often as might be necessary.

It is sometimes necessary to do this to young
children, and it must be remembered that in
them the Testicle is much lower than in adults,
8*

90 DISEASES OF THE TESTES.

and greater care is, therefore, needed not to
wound it.

A simple dressing of mild ointment, or even of
wet cloths, is all that is needed after the injection is
withdrawn.

Some practioners have used Setons, and others
Galvanism, to cure Hydrocele, but though each
method has been successful in some cases, yet they
are not more so than the injection, which is much
more simple, and causes much less pain. Either of
these methods may, however, be tried, if that fails.

After the water is drawn off, the Testicle should
be carefully examined, as it can then be readily
felt, because if there be any swelling of it, or any
indications of cancer, the injection must not be
thrown in till that has been benefically treated.

In some persons the water will accumulate in
spite of all, and it is necessary to discharge it fre-
quently. In infants it will often disappear spon-
taneously, without any treatment, but it rarely does
so in adults, though I have known some in whom
brisk exercise alone would disperse it.

Sometimes this form of Hydrocele is congenial,
or exists from birth. In these cases the fluid
descends from the Abdomen, the opening between
it and the Scrotum, by which the Testicle descend-
ed, not having closed. Many persons have been
deceived by this affection, and have taken it for a
rupture, but a little careful examination will soon
disclose the truth. By gently compressing the
tumor the fluid will rise into the Abdomen, through
the ring, and return again when the pressure is
withdrawn. To a certain extent this trouble is
more general than is supposed, and is frequently
ascribed to wrong causes. It is advisable to have

DISEASES OF THE TESTES. 91

it attended to as early as possible, because there is
danger, if left over the first month, of its continuing
during the whole of childhood, or perhaps even till
adult age, and leading to other derangements.

In the early stages, and sometimes even after it
has existed long, it is possible to cure it in a very
simple manner. The water must be gently pressed
back into the abdomen, and then a truss or bandage
of some kind must be worn, so constructed that the
pad will press exactly on the ring, and thus prevent
the fluid from returning. In a short time the pas-
sage grows up, and there is then no further danger.
The period required to effect a cure varies much in
different cases ; thus in some it will be complete in
two or three weeks, while in others it requires as
many months, or even much longer. Cold lotions
must be used in these cases as with adults.

In case of failure, with these means, which will
sometimes happen, the only other remedy is the
injection, the same as already described. The
operation is precisely the same as for an adult, but
must be conducted with more care, there being
more risk of serious inflammation. It must be
recollected also that while the injection is being
made the upper part of the Scrotum must be held
firmly together, just by the ring, to prevent the
injected fluid from passing up into the Abdomen,
which it would otherwise do, and perhaps cause
serious trouble. A truss or bandage must be worn
for some time after the operation, to prevent any
more fluid coming down, and also to retain the
bowels in their place.

Third Variety of Hydrocele. — In this form of Hy-
drocele, as already explained, the seat of the watery

92 DISEASES OF THE TESTES.

effusion is not in the Scrotum, but in the Spermatic
Cord. It may occur in two ways, first in the sub-
stance, or cellular tissue of the cord ; and secondly,
within certain cavities in the sheath or tube itself.

The first form of Spermatic Hydrocele is very
rare, and is but seldom of much account. It is of
similar in its nature to the first form of Hydrocele
in the Scrotum, or Hydrocele (Edematodes ; in fact,
it is the same disease only confined to the sheath of
the spermatic cord. Its causes are also in all
probability the same, and it requires the same
treatment. When it results from general dropsy,
which is usually the case, no cure can be expected
until that is remedied.

The palliative treatment must consist in wearing
a bandage and using cold astringent lotions, and it
is but seldom that anything more is required.
Occasionally, however, the swelling becomes so
great as to cause serious inconvenience, and the
patient insists upon having relief immediately.
Under such circumstances the only mode of pro-
ceeding is to open the swelling, and so let the fluid
escape. There is, however, some danger in this,
and in most cases it is better not to perform the
operation. Many persons have mistaken this affec-
tion for a small hernia, or a swelled vein.

The other form of Spermatic Hydrocele is
usually termed Encysted Hydrocele of the Spermatic
Cord, because the fluid is contained in one or more
sacs. The swelling in this case is in the form of
an egg, and situated between the Testicle and the
groin. It is usually firm to the touch, with no
fluctuation, and perfectly distinct from the Testicle,
which may be felt below it. Sometimes the sac
of fluid is near to the ring, and can be pressed up

DISEASES OF THE TESTES. 93

into the Abdomen, so that it will disappear, but
only to return immediately the pressure is with-
drawn. In such cases it may easily be mistaken
for a hernia or rupture, unless proper care be
taken. On examination, however, it will be found
that the vessels of the spermatic cord can be dis-
tinctly felt even when the tumor is down, by merely
pressing it on one side, which is not the case in
rupture. The functions of the bowels also are not
interfered with in Hydrocele, while they are very
much so in Hernia, when it is down.

Occasionally the watery tumor descends much
lower than usual, and may then be taken for
Hydrocele of the Tunica Vaginalis. It is only
requisite, however, to remember that when the fluid
is contained in the Scrotum it surrounds the Testicle,
which can scarcely be felt through it, but when it
is contained in a sac, in the sheath of the cord, it
is always either above or on one side of the Testicle,
which is quite separate from it.

The treatment should consist at first in fomenta-
tions, as directed for the other varieties, and in
keeping the bowels perfectly free. This plan is
the best one with children, who are often afflicted in
this way. A mixture of two parts alcohol and one
of water, is very good to use night and morning, or
either of the recipes already given. With regard
to internal medicines, they are perhaps less proper
in this variety than in either of the others, but if
thought necessary there are none better than those
before advised.

Sometimes, especially in children, a small punc-
ture may be made and the fluid let out, but in
adults this is often of little use, as the sac fills up
again. To prevent this the port wine injection

94 DISEASES OF THE TESTES.

must be used, or the sac must be fairly cut out.
Some practitioners merely lance it open the whole
length, and Sir Astley Cooper was accustomed to
insert a Seton, a plan which I have known to suc-
ceed frequently, both in children and adults. The
particular plan to be pursued must, however, de-
pend upon the circumstances of the case, and I
should advise every one to hesitate about submitting
to any operation, if they can keep tolerably com-
fortable, and get no worse without it, which they
nearly always can if they will persevere with the
simple directions given, and wear a suspensory
bandage.

In children the following lotion, applied freely
two or three times a day, will in most cases cause
the water to disperse without any further treatment.

R. Hydrochlorate of Ammonia, one ounce ; Dis-
tilled Vinegar, four ounces ; water, six ounces.

The same lotion, with half the water, will also
be excellent for adults.

SARCOCELE, OR CHRONIC FLESHY SWELLING OF THE
TESTICLE.

This affection is the real swelled Testicle, or
chronic fleshy enlargement of the substance of that
organ.

The causes that lead to this enlargement are
various, and some of them not yet understood. Can-
cer and Scrofula are perhaps the two most frequent
causes, but it often arises when they do not exist,
and when no other immediate agency can be
detected. Sometimes a chronic swelling will take
place in the Testicle, and after existing for a con-
siderable time, entirely disappear without any evil

DISEASES OF THE TESTES. 95

consequences. More frequently, however, the re-
sult is more serious and a malignant tumor is even-
tual1, y developed, either Cancerous, Scrofulous, or
Sarcohiatous.

Sarcomatous Tumors are of various kinds, and
are the same in the Testicle as in other parts of the
body. The most frequent kind, is that called
Medullary, because it resembles the substance of the
brain. It is a most dangerous affection, and unless
attended to at the very earliest moment is nearly
sure to be fatal. The whole substance of the Tes-
ticle is converted into a kind of white pulp, similar
in appearance to the brain, and in a short time the
disease is propagated along the absorbents till it
attacks all the neighboring parts. The glands in
the groin soon swell to an enormous size, and
slough and bleed, and eventually the lower part of
the abdomen becomes affected in the same way till
the parts are all destroyed and the patient sinks.
This is thought bv some to be the same disease as
Fungus Hamatodes, and in many respects it closely
resembles Cancer. There is, however, sufficient
difference between them to enable the surgeon to
distinguish with ease, but to the patient the distinc-
tion is of little consequence, each being equally
dangerous, and the treatment being the same for
both.

Sometimes the mistake may be made of con-
founding Sarcoma with Hydrocele, unless a strict
examination be made.- In Hydrocele it must be
recollected the swelling begins at the bottom, and
gradually extends upwards to the abdominal ring,
but no farther ; it is also semi-transparent, and
fluctuating. In Sarcoma, on the contrary, the
swelling is evidently in the whole substance of the

96 DISEASES OF THE TESTES.

Testicle at once, and extends upwards into the
spermatic cord ; it is also not in the least transpa-
rent, and is much heavier than water. From want
of attention to these points of difference the swelled
Testicle has often been punctured, to let out the
water.

Cancer in the Testicle is precisely the same in its
origin and progress as in any other part of the
body. The Testicle becomes the seat of a hard
tumor, through which dart deep-seated lancinating
pains, which shoot up to the loins, and down the
limbs. Eventually this becomes an open sloughing
ulcer which destroys the substance of the organ and
gradually extends to the abdomen, causing a pro-
fuse offensive discharge a'nd a rapid impairing of
the general health.

Scrofula of the Testiclg. — This disease is scarcely
ever met with except in those who plainly exhibit
a scrofulous habit of body. It causes a swelling
of the Testes similar to that of Cancer in its feel
and appearance, but unaccompanied by any of the
lancinating pains. When the tumor is cut into, it
seems filled with a whitish or yellow substance like
curds or soft cheese, along with a small quantity of
pus. The commencement of this affection may be
very slow and insidious, and for a long time, even
after it has become fully established, nothing seri-
ous may be indicated. There is nothing to alarm
the patient much till the tumor breaks open and
becomes an ulcer, its progress then is often very
rapid, and all the neighboring parts speedily become
diseased and destroyed.

The causes of that peculiar tendency to Scrofula
and Cancer which many persons exhibit are as yet
unknown to us, they are, however, in all probability

DISEASES OF THE TESTES. 97

what is termed Constitutional, and not produced by
any accidental agency after birth, though there
may be many causes that will excite or call out
these diseases, when they would otherwise have
remained dormant, either for a longer time or per-
haps altogether.

The Treatment of the various forms of Sarcocele
above described may be given in a few words, for
unfortunately but little can be clone with them.

In some few cases of simple swelling, of the
Medullary or fatty character, it may perhaps be
dispersed, in the very earliest stages, by using
Leeches and cold lotions or mercurial ointment
externally, with mercury and iodine internally, but
this can seldom be depended upon. Unless such
means evidently decrease the swelling immediately,
no further time should be lost with them or the
chance may go by of doing good by other means.
The removal of the Testicle, by an operation, offers
the only chance of effecting a certain cure, and
this is of no use either unless performed at first, for
if the disease has progressed till the neighboring
parts are attacked the removal of the Testicle will
not check it. Unfortunately many patients delay
having this necessary operation performed till it is
too late, and they then conclude it is in itself of no
use. It must be borne in mind that some of these
cases are very rapid in their extension, and that the
surrounding parts may be deeply affected without
giving any sign of it. In Cancer especially it is
necessary to operate as early as possible, for even
when the Testicle itself shows but slight signs of
the disease, it may have extended to the loins and
abdomen. There have undoubtedly been many
cases of Sarcocele, of all the above kinds, that have

98 DISEASES OF THE TESTES.

been entirely cured by removing the Testicle, and
have never appeared again.

In general only one Testicle is diseased, and that
only needs removing, though there is danger of
both becoming affected by delay. The operation
itself is comparatively simple, and not attended
with so m^ch pain or danger as many might sup-
pose it to be.

It is very common, as before remarked, to find
Sarcocele accompanied by Hydrocele, and fre-
quently on evacuating the water in Hydrocele the
Testis is found enlarged, though there were prev-
iously no signs of it.

It is generally conceded that blows or other
violence may produce simple induration or hardness
of the Testicles, leading to medullary or fatty
tumors, but not to Cancer or Scrofula, though they
may excite such diseases to break out. The too
frequent irritation of bougies and injections is also
suspected of injuring in the same way.

FUNGUS OF THE TESTICLE.

This affection is different from either of those
previously described, though it has some resem-
blance, at certain stages, to Cancer. It is for-
tunately more capable of being beneficially treated,
however, and is not so likely to extend to other parts.

It is supposed to be caused by bruises or other
violence, or by Gonorrhoea and Gleet, particularly
when injections have been used. The first indica-
tion is a simple swelling without pain, which bursts
and forms an abscess discharging pus, and from
the opening a Fungus begins to protrude. This
Fungus may attain an immense size, if not remov-

DISEASES OF THE TESTES. 99

ed, extending to the abdomen and becoming very
virulent. The discharge also may become so pro-
fuse as to cause much general debilitv and con-
stitutional irritation.

In the first stages of the swelling, when it is
known to arise from external violence, it may some-
times be reduced by Leeches, warm fomentations,
and poultices, with purgatives used internally, and
even after the abscess has opened fomentations and
poultices may be sufficient to prevent any extension
of the mischief. When the Fungus has appeared
these simple means become useless, and resort must
be had either to caustic or the knife to remove it.
In my opinion the caustic is the best remedy, and
seldom fails to remove the diseased growth without
any injury to other parts. If the disease has not
progressed too far it may often be cured without
injuring the Testicle at all, though it was formerly
thought necessary to castrate in every case, and
some practitioners even do so now.

I once knew a man who had one of these Fungous
growths, arising from a bruise, who was cured by
the daily use of powdered burnt alum, dusted over
the Fungus, and followed by a warm Linseed poul-
tice. This was done morning and night, and by
these means only, combined with the use of simple
purgatives, and the solution of hydriodate of potassa
internally, as directed for Hydrocele, he fully
recovered in about six weeks. The Testicle, how-
ever, remained hard, and in all probability its power
was lost.

In all cases of bruising, or other violence, the
timely use of rest, poultices, and warm fomenta-
tions, may prevent many of these evils.

There are several other kinds of tumors and

100 DISEASES OF THE TESTES.

swellings of the Testicles occasionally met with,
besides these mentioned, but they do not differ essen-
tially either in their nature or treatment, and often
it is scarcely possible to distinguish between thern.
One peculiar form of Cancer is frequently met with
in England amongst chimney-sweeps, and is caused
bv the irritation of the soot lodged in the furrows
of the Scrotum. It is met with sometimes, but
rarely, on the hand, or foot. It is commonly termed
the Sweeps' Cancer.

HERNIA HUMORALIS, ORCHITIS, OR INFLAMMATION
OF THE TESTICLES.

This sometimes appears to arise from some un-
known constitutional cause, and comes on very
slowly, but more usually it is from some obvious
agency, and assumes from the first an acute form.
It arises frequently from blows, falls, hard riding,
and strains, but most generally from the use of injec-
tions and bougies, in Gonorrhoea, and stricture, or
from the performing of operations like those for
Hydrocele. I have also known it to follow intense
sexual excitement, where gratification was impossible
and the semen had no tendency to escape involun-
tarily. In children it very frequently follows, or
accompanies the Mumps.

Inflammation of the Testicle usually commences
with slight pain and soreness in the part, attended
by swelling, which is at first soft and yielding, but
gradually becomes hard, and sometimes hot and
very painful. The Scrotum loses all its roughness
by swelling so much, becoming smooth and red,
and occasionally so tender that it can scarcely be
touched. As the inflammation progresses the

DISEASES OF THE TESTES. 101

swelling extends up the spermatic cord, and severe
pains may be felt in the loins, and sometimes even
in the limbs, till the patient suffers the most ex-
cruciating agony.

In many, even of the most severe cases, but little
pain is experienced and the inflammation will sub-
side, under proper treatment, leaving no evil effects
whatever behind. There is danger, however, of its
being followed by abscess, or hydrocele, if neglect-
ed, even if it does not excite tumor or Fungus. A
loss of sexual power is also apt to follow inflamma-
tion of the Testicle, either from its deranging the
structure of the organ or from its obliterating the
passage in the Vas Deferens, and thus preventing
ever after the passage of the Semen from the Tes-
ticles to the Urethra.

Orchitis arises much oftener from Gonorrhoea than
any other cause, the inflammation extending from
the Urethra, along the Vas Deferens, till it reaches
the Epididymis, and finally the Testicle. The
Epididymis is always, first attacked in these cases,
and very frequently the disease extends no further,
when it is called an Epididymitis. If it reaches the
Testicle it is then called Hernia Humoralis.

When the inflammation accompanies Gonorrhoea
it will generally be found to arise whenever the
discharge is suddenly checked, and immediately
the discharge is allowed to return the inflammation
ceases. This shows the close sympathy there is
between the Urethra and the Testes, and what
danger there is in irritating the Urethra in any
way. I have known inflammation of the Testes
arise in one hour after using a strong injection.

The treatment of this severe affliction must. con-
sist, in the first place, in perfect rest, on the back,

102 DISEASES OF THE TESTES.

the Scrotum being supported by a suspensory ban-
dage, or truss. Cold lotions must be freely and
frequently used, and the bowels opened freely with
salts or castor oil. No stimulating food or drink
must be taken, and the mind must not be agitated,
nor the feelings excited in any way. The best
lotion is a mixture of half a pint of water to half a
pint of alcohol, with a large spoonful of laudanum
added. If the pain be very severe this lotion may
be made hot, or a hot linseed or bread poultice may
be applied. A hot bath is also frequently of service.

A perseverence in these means will usually
reduce the inflammation and pain in one or two days,
unless the exciting cause continues to operate. In
very severe cases, however, particularly those from
bruises, it may be necessary to apply Leeches, or
to open some of the veins of the Scrotum, which
nearly always gives relief if the blood flows freely.
If the pain be so bad that the patient cannot rest he
may take twenty or thirty drops of Laudanum at
bed-time, in a little flax-seed tea or barley-water,
or in simple water alone, if these are not to be
obtained conveniently. The following pills are the
best for this purpose, however, when they do not
disagree with the stomach, which unfortunately
they are apt to do, but they may be tried.

R. Opium, with soap, twenty grains ; Camphor,
half a drachm ; to be made up into twelve pills, with
as much simple mucilage as may be requisite. One
of these may be taken every six hours if requisite.

The following ointment, applied externally, may
also give great relief from pain when the lotion
fails to do so.

R. Belladonna Ointment, two ounces ; Camphor,
one drachm ; Paregoric Elixir, one drachm.

DISEASES OF THE TESTES. 103

This must be mixed into an Ointment, and a
portion rubbed carefully over the tender parts, as
often as the pain becomes severe.

When the inflammation has been fully subdued
there is danger of the Testicle being left perma-
nently hardened, or indurate-d, which is nearly sure
to destroy its power, if it does not originate other
diseases. To prevent this, if the slightest hardness
remains, it must be frequently bathed with hot water,
and poulticed, or if these fail it must be rubbed
with the Camphorated Mercurial Ointment. Galva-
nism has been used with success when the hard-
ness resisted all other means, and as it is a safe
remedy, it may he readily tried. The only internal
medicine likely to be of use is the solution of
Hydriodate of Potassa, before directed, and even this
should be but seldom taken. The regular use of
the Camphorated Mercurial Ointment, followed by
hot fomentations, is the most generally successful
treatment.

The best remedy in some cases of acute Orchitis,
particularly when arising from the sudden stoppage
of a Gonorrhoeal discharge, is compression. This is
effected by means of strips of sticking plaster,
which are stuck firmly around the organ, and alsO
passed underneath, the pieces being about a quarter
of an inch wide, and long enough to go round and
meet. These of course cross each other, and when
drawn pretty tight, and made to adhere fast, they
press considerably, and draw the whole organ
together. The parts require to be shaved to apply
them, and they must be re-applied as often as they
work loose, or as fast as the swelling shrinks. In
most cases the patient experiences great and im-
mediate relief from this application, owing to the

104 DISEASES OF THE TESTES.

support it gives ; it must always be used, however,
with the suspensory bandage.

Compression is, in general, only appropriate in
cases of acute Orchitis arising from Gonorrhoea,
though it may be advantageously resorted to, in
some few instances, when it originates from other
causes. I have used it when the swelling arose
from intense sexual excitement, and also in one or
two instances from blows, and with advantage, but
generally the treatment before given will obviate
the necessity for compression, if it be persevered in.
Latterly the compression has been effected by
means of Collodion, a substance made by dissolving
gun cotton in ether, which sticks much more forci-
bly, and is applied more readily.

The symptoms of Epididymitis are the same,
and so is the treatment, as when the whole organ is
attacked, which it is nearly sure to be eventually,
if the Epididymitis continues.

There is always reason to fear that a severe
attack of Orchitis will permanently injure the Tes-
ticle, more or less, by obliterating some of the
Seminal Tubes, even if it does not close the Vas
Deferens, or harden the Epididymis. One Tes-
ticle may, however, be inflamed, and suffer, while
the other remains perfectly sound. After having
been once inflamed the Testicle appears more sus-
ceptible of the same misfortune again, so that
those who have suffered from it should be as careful
as possible to avoid subsequent attacks, or the evil
effects will probably increase each time. Impotence
not unfrequently follows Orchitis.

Sometimes the inflammation ends in suppuration,
the matter escaping by numerous little sinuses or
openings, which eventually close and heal when all

DISEASES OF THE TESTES. 105

is discharged. In all these cases, however, the
Testicle is more or less wasted, and sometimes
entirely destroyed. At other times the pus will not
discharge at first, but assume the form of a firmish
curdy mass, similar to the substance of the brain,
and remain for a long time. The organ is then
much more liable than before to inflammation, and
its internal structure gradually undergoes a change
by which its secreting powers are totally lost. In
some of these instances the Testicle becomes nearly
as hard as a stone, and on being dissected appears
much like cartilage or bone.

In some persons Acute Orchitis much resembles
Rheumatism, being affected by the changes of the
weather or by exposure, and coming and going
again in a short time. Indeed, some writers speak
of it then as Rheumatism of the Testicle, and treat it
the same as that affection in other parts of the body.
I have known some men so extremely sensitive in
this organ that an attack of Orchitis was sure to
follow if they merely pressed the Testicles on
crossing the limbs, and especially if they rode on
horseback. In fact, many a severe case has arisen
from being thrown forward upon the pommel of the
saddle.

Inflammation of the Testicle sometimes appears
in very young infants, not more than a few days
old, and without our being able to assign any
cause. I have thought sometimes that it arose from
Teething, and at other times from an improper
mode of carrying the child, by which these organs
were bruised. I saw one instance wherein the in-
flammation appeared on the day of birth, which was
very severe. In general, these infantile cases can
be cured by simple fomentations, or cold lotions,

106 DISEASES OF THE TESTES.

with a dose or two of castor oil. When very severe
a Leech may be applied, and three or four grains
of the Powder of Mercury and Chalk given. When
arising from Mumps it usually subsides when the
primary cause is removed, though it may remain
afterwards, and must then be treated as above
advised.

It is somewhat disputed among medical men
whether these inflammations in infants ever perma-
nently injure the Testicle or not, but I am persuad-
ed they often do so, and, in all probability, many a
man has been made impotent for life by this affec-
tion when a child. It is, therefore, of the first
importance not to neglect this trouble, though it
may be but slight, as the after effects may be
serious.

It is proper to remark here that the Mumps arise
in adults as well as in children, and that they may
affect the Testicles, and cause impotence, as well
at one period as at another. Such cases as these
afford a singular proof of that remarkable sympa-
thy which exists between distant parts of the body,
but the nature of which we cannot explain.

Either of the following Recipes give excellent
cooling lotions, applicable to all cases.

Jk. Lime-water, one ounce ; Alcohol, seven
ounces ; mixed together.

R. Hydrochlorate of Ammonia, one drachm ; Cold
Spring-water, five ounces ; Alcohol, one ounce ;
mix together.

The last lotion is an excellent one to apply to the
Scrotum and Perineum. In many persons, how-
ever, hot fomentations succeed much better than
cold lotions.

It is often very beneficial, particularly when the

DISEASES OF THE TESTES. 107

pain is severe, to cause a little nausea or vomiting.
For which purpose a quarter of a grain of Tartar
Emetic may be given every three or four hours, till
the effect is produced. This frequently gives great
relief, and in a short time, when all other means
fail.

In very obstinate cases, attended with pain, two
or three grains of Calomel should be given, at bed-
time, mixed with eight or ten grains of Dover's
Powder. This may be given two or three times a
week.

It is sometimes a good plan to use the Plaster of
Ammonia and Mercury to strap the Testicle with,
in the manner before described, so as to gain the
advantages of Compression and the effects of Mer-
cury together.

If the inflammation _and tenderness all subsides,
but the swelling and hardness continues, the follow-
ing solution may be rubbed over the Scrotum every
three or four days.

R. Iodine, one drachm ; Iodide of Potassium, half
a drachm ; Alcohol, one ounce ; dissolve all together.

In many persons, particularly those of a Scrof-
ulous habit, Acute Orchitis has a tendency to
assume the Chronic form, after the first severe
symptoms have subsided, and this is perhaps a
worse state than the other. In Chronic Orchitis a
deposit of yellowish matter takes place, in different
parts of the Testicle, at first soft but gradually
becoming harder, till at last the organ feels like
a stone. This matter blocks up the Seminiferous
Tubes and destroys their power of secretion, so
that impotence ensues. It was formerly the custom
to call such cases Schirrhus, but this is improper, as
it might lead to the idea that they assume a malig-

108 DISEASES OF THE TESTES.

nant form, which is not the case. Chronic Orchi-
tis may either follow from the acute form, or it
may arise spontaneously, like Scrofulous affections
of other parts ; and it also frequently follows a
long course of intemperance or licentious indul-
gence, and may even be produced by the long con-
tinued and injudicious use of Mercury.

This form of the disease may give rise to but
little inconvenience for a long time, though the
swelling may be of considerable size, unless a
blow, or strain be experienced, when the symptoms
become immediately acute, and relief is sought for.
Usually in a few weeks the swelling is observed to
point in some particular part of the Scrotum, and
eventually it breaks, discharging some pus, together
with a Fungus-looking body, which appears rough
and bleeding. In a short time the opening enlarges
and more or less of the Testicle itself passes
through, the Whole forming a granulated tumor of a
yellowish white color, studded with pale red or
black patches. This tumor is tightly embraced
round its neck by the edges of the opening through
which it passed, and which become very thick and
red. A thin watery discharge flows from it, often
mixed with semen, but rarely with blood.

As soon as this break occurs, and the parts pass
through, great relief is felt, and the disease may
remain for a long time without undergoing any
further change. The tumor itself is rarely tender,
but may be handled, cut, or burnt with caustic,
with but little inconvenience. It is not unusual to
find this singular protrusion in Scrofulous children
who have had inflammation of the Testicle.

It was formerly the custom always to remove the
whole Testicle when afflicted with this Fungous

DISEASES OF THE TESTES! 109

growth, but now the practice is seldom resorted to.
The protruding part is cut off with the knife, or
burnt off with caustic, and the skin of the Scrotum
being then brought over it the wound is healed and
no further trouble is experienced. In many cases
a cure is even effected spontaneously, or by means
of a simple wash of six grains of Nitrate of Silver
to one ounce of water, with some internal alterative
medicine.

The best medicine in Chronic Orchitis is Blue
Pill, Jive grains of which should be given every
night, with one grain of Opium, till the gums feel a
little sore.

In some cases a better treatment is to administer
the Compound Extract of Sarsaparilla internally,
and sprinkle the Fungus itself with equal parts of
powdered savin and sulphate of copper. Occasion-
ally varying the medicine by giving a little of the
Wine of Iron, particularly if the patient be weakly-
and sinkino;.

It must be admitted, however, that Inflammation^
of the Testicle is, in any form and under any mode
of treatment, a disease extremely dangerous to the
patient's sexual powers, though it may not com-
promise his life, nor interfere much with his general;
health.

OSSIFICATION OF THE TESTICLE.

In some few cases the Testicle has been known
to Ossify or become more or less converted into*
Bone. The causes of this degeneration are un-
known, and unfortunately we know of no remedy.
I have thought, in some few cases I have seen,
that it was more likely owing to excessive con-

10

110 "DISEASES OF THE TESTES.

tinence than anything else, but it is impossible to
decide.

The Ossification generally commences in the
middle, and may be felt like a hard kernel, which
gradually extends till the whole organ is affected.
In all cases when a hardness of this kind is felt im-
mediate resort should be had to fomentations and
poultices, because it may be but a simple indura-
tion which they will remove.

It is propable that Ossification and induration
most frequently arise from Orchitis, particularly
when there has been many consecutive attacks.

ARREST OF DEVELOPMENT AND WASTING OF THE

TESTES.

The Testes, like other parts of the body, are
liable to be arrested in their development, from
-causes unknown to us, and this arrest may either
be permanent or the development may be comple-
ted at some after period of life. I have known
instances of men, at various ages, with Testes
■remarkably small, and passions nearly dormant, in
•whom a sudden development took place from the
•sight of some female who excited their desires to
an unusual degree. In all probability these per-
sons would always have remained as they were,
but for this occurrence, as many others similarly
circumstanced do ; and we have thus a proof of the
decided influence that the awakened feelings may
have on physical development.

In one instance where I was consulted, in a case
of this kind, the left Testis was about the size of a
small hazel-nut, and the other still smaller, the per-
•son being about twenty-eight, and possessing the

DISEASES OF THE TESTES. Ill

usual feelings of his sex, though in a slight degree.
Many circumstances induced me to think that the
organs were healthy, and that in all probability
their further growth would ensue, under proper
treatment, and from the new impetus given to his
desires by his wish to marry. I, therefore, advised
a stimulant plan of treatment, similar to that which
will be directed in a subsequent article, and advised
him to wait patiently. The result justified my
opinion, the organs began to enlarge very soon, and
in two years' time were of full average size, so that
he had no misgivings whatever about marrying.

It is very often the case that persons who had
Scrotal Hernia in childhood have the Testes small,
owing to the pressure on the cord of the instrument
worn to cure it, and with some who have had
Mumps their full growth is never attained.

Any causes that prevent the full supply of blood
from going, to the Testes will prevent their growth,
or cause them to waste, and it is from this cause
that many such cases arise. If the spermatic
arteries be small, which supply them with blood,
they do not receive sufficient nutriment, and, there-
fore, cannot grow nor secrete much semen. These
arteries are very long, and exposed to several
causes of injury as they proceed through the abdo-
men, so that they frequently become more or less
injured, and the Testicles suffer in consequence.
Sometimes they are pressed upon by the other parts,
in passing through the ring, and at other times they
are affected by aneurism or their walls thicken
and partly close up the passages. In old people
the spermatic arteries are very apt to become more
or less obliterated, and this is the chief cause of
that wasting of the Testes so often seen at that

112 DISEASES OF THE TESTES.

period of life. To fully prove this the spermatic
artery of a dog has been tied, leading to one of the
Testes, and that in a short time was completely
wasted away, while the other remained perfect. It
has even been proposed to perform this operation,
which is comparatively simple, instead of castration,
when we wish to destroy the procreative power in
animals. Such facts make it evident that the power
of the Testes, and consequently the amative propen-
sity of any man, depends materially upon the size of
the spermatic arteries, probably much more so than
upon any peculiar structure of the brain. It is cer-
tain that if these arteries be destroyed in early life
no amativeness can ever be felt, nor any procreative
power be established. A knowledge of this fact
teaches us that, the extent, both of the power and
the propensity is very much, if not entirely, under
our control, if the supply of blood admitted to the
Testes can be duly regulated. This is a point never
before attended to in medical practice, that I am
aware of, but I have satisfied myself of its correct-
ness by repeated experiments, and I. look upon it as
being of the greatest value. There are many
means by which the amount of blood flowing to the
Testes may be regulated to a great extent, some of
them increasing and others decreasing it, as I have
shown in many of the cases described. It is often
the case that badly fitted Trusses, by pressing on the
arteries, will cause the Testes to waste, while, on
the contrary, an ill-made suspensory bandage or
even tight clothing, by charing the parts, will draw
the blood to them till they are intensely excited,
or even till inflammation ensues. This shows us
what principle to act upon in practice, adopting the
appliances to the peculiar circumstances of the case.

DISEASES OF THE TESTES. 113

Hot stimulant applications will bring the blood to any
part, while cold astringent ones will drive it away,
and these alone, judiciously used, will often accom-
plish more than all the internal medication, or mere
moral chiding ever yet tried. Besides these, how-
ever, there are various other means, mechanical
and medical, which will be described as we pro-
ceed, and sometimes instruments may be construct-
ed, for special cases, that will effect almost miracul-
ous results.

I have sometimes used a modification of the
instrument called the Congester, which will be de-
scribed in a subsequent article, for the purpose of
drawing; blood to the Testes and of enlannno- per-
manently the spermatic artery. In short all the
means resorted to for causing an increased flow of
blood to the Penis may be used, to a certain extent,
and in a modified form, to the Testes. As before
remarked, I have had numerous patients, of all
ages, whose Testes had always been too small and
inactive. for the performance of their functions, and
yet, by appropriate treatment, most of them have
attained their proper growth and full powers.

Wasting of the Testes, after they have been of a
proper size, is a much more serious matter, as it
usually results from some disease that is likely to
permanently destroy them,, though occasionally the
causes of it are under our control, and the loss may
be repaired. In addition to all the causes above
enumerated that prevent development, we may also
enumerate Hydrocele and Hematocele, of long
standing, and also Scrotal Hernia, all of which may
cause the Testes to waste by the continued pressure
which they exert. Spermatocele will also lead to
the same result as stated in the article on that dis-

10*

114 DISEASES OF THE TESTES.

ease. Too long continued and strict continence, will
also waste the Testes, in many persons, notwith-
standing what is said to the contrary by some
writers. These organs can no more preserve their
powers when entirely disused then others can, nor
is it in any way conducive to their health to leave
them totally inactive. I am aware that it has been
said that those who take vows of celibacy still pre-
serve these organs, and in full development, but
that has very little weight because no one can tell
what may have been the actual observance of those
vows, nor how far involuntary action may have
taken place. I am myself fully convinced, from
numerous observations, that total inaction of the
Testes, in every form, is most certainly followed, in
most cases, by their wasting and decay. I have
known men who boasted that they were strictly
continent, and had been so for years without any
apparent injury of this kind, but on proper ex-
amination I have satisfied them that the semen
passed almost constantly, in the Urine. It is scarce-
ly necessary to say that such an action was unna-
tural, and decidedly injurious. The assertion,
made by some theorizing physiologists, that the
semen, when not discharged, is absorbed into the
blood and invigorates the system, is unsupported
by a single fact, or even by plausible reasoning,
and, therefore, requires no refutation. Many a
man who has prided himself upon his immaculate
purity, and denounced those who were unable or
unwilling to totally abstain, has been himself the
victim of a constant pollution, both unpleasant and
injurious. I have here spoken openty and fully, as a
medical man ought, and no one with common sense
or honest intentions, can accuse me of encouraging

DISEASES OF THE TESTES. 115

anything approaching to licentiousness in what I
have said. True virtue consists in a proper use of
those powers given to us, and not in their total
abrogation.

There are several causes of a nervous character
that will also lead to wasting of the Testes, such as
paralysis of the lower part of the body, or injury
of the spine in the neighborhood of the Nerves
leading to them, and sometimes even long-continued
anxiety of mind. The most frequent causes, how-
ever, are probably Inflammation and the Mumps,
particularly in early life. Excessive indulgence
not unfrequently ends in gradual wasting, and Mas-
turbation still oftener, especially if accompanied by
intemperance in strong drink. I have known in-
tense excitement followed by inflammation and
subsequent wasting, in a very short time, and I have
known inebriates wake from their dreams of in-
toxication to find themselves impotent, in numerous
instances.

There are some drugs which exert an influence
this way occasionally, and to a very marked degree.
Mercury will in some, if long continued, so will
Opium, and Iodine still more frequently, and
decidedly. It is, therefore, the duty of the physi-
cian to watch well the effects of all such remedies.
Tobacco, I am satisfied, is decidedly injurious to
many men, and when used to excess will impair the
tone and energy of these organs to a great extent ;
in several instances [ have had good reason to
attribute wasting of the Testes to its influence.

Injuries of the head must also be enumerated as
occasional causes of wasting of the Testes, though
we cannot explain why. Several instances of the
kind have been noticed, particularly by Army Sur-

116 DISEASES OF THE TESTES.

geons, and the fact is established beyond doubt.
Baron Larrey gives a remarkable case, which came
under his own notice. It was that of a soldier, a
healthy, robust man, with strong sexual propensities
and endowments, who had a portion of the back
part of his head cut off by a sabre wound. He
recovered from the wound, but lost the senses of
sight and hearing on the right side. Pain was also
experienced down the spine, and a peculiar creep-
ing feeling in the Testicles, which also began to
waste, and in fifteen days were no larger than beans.
He completely lost all desire for sexual enjoyment,
and apparently even all remembrance of it. M.
Lallemand also mentions a case, of a French sol-
dier, similarly injured in the expedition to Algiers,
who speedily experienced wasting of the Testes,
loss of sexual desire and all power of erection.

Bruises of the Testes are nearly certain to be
followed by inflammation and wasting, if severe,
and few injuries cause more acute physical suffer-
ing, or affect the system more generally. Sickness,
vomiting, and death-like fainting generally result
from bruises of the organs, and sometimes even
delirum. Constant pressure, from almost any cause,
even though slight, will also cause wasting, as is
seen in many persons who pass much time on horse-
back. It was even the custom formerly, in Tur-
key, to make Eunuchs by squeezing the Testes
instead of Castrating, and some persons operate
upon animals in the same way now, when they
wish to emasculate them, the squeezing causing
them to waste away. Cutting these organs, with
sharp instruments, so as not to bruise them, may
not be followed by any evil effects whatever. Many
instances have been known of their being cut and

DISEASES OF THE TESTES. 117

torn considerably, both by accidents and during
surgical operations, but with no detriment to their
powers, unless inflammation or mortification has
ensued. Fanatics and insane people have injured
themselves in this way frequently.

All that we can do in those cases of wasting of
the Testes is to find out, if possible, the immediate
or exciting cause, and remove it. Very frequently,
however, no cause whatever can be ascertained,
and often when it can be it is not under our control.
Still no such case should be left unattended to, and
its treatment, if any be thought advisable, should
not be neglected a single day.

TUBERCULAR DISEASE, OR CONSUMPTION OF THE
TESTICLE.

This is essentially the same disease as Consump-
tion of the Lungs, being characterized by the pro-
duction of Tubercles in the substance of the organ,
which eventually suppurate and break, and entirely
destroy its substance. In most instances, the pa-
tients are either decidedly Scrofulous or evidently
disposed to consumption, and generally both Testes
are attacked, either together or consecutively.

The symptoms are usually a slight uneasiness,
in some particular part of the Testicle, which is
soon followed by violent swelling, either in the
body of the organ or in the Epididymis, but witfc
very little acute pain, if any. The swelling feels
uneven, or studded with little lumps, one of which
eventually projects and bursts, discharging a quan-
tity of pus, and thick curdy matter of a yellowish
color. It may, however, be a year or more after
the swelling occurs before it breaks, though when

118 DISEASES OF THE TESTES.

one opening is formed others are apt to follow.
The opening evidently communicates with the in-
terior of the organ, and after venereal excitement it
is not unusual for semen to flow from it, along with
the pus.

In some few cases the Tubercle will heal, and
the wound close, leaving the Testicle only partially
wasted, but more frequently they continue to dis-
charge till it is all completely gone, or till the
whole system is so affected that death ensues. Oc-
casionally the whole Testicle will pass through the
wound, and will remain protruded till it is entirely
gone.

This affection occurs sometimes in children, of a
scrofulous habit, and completely destroys the Testes
in a short time.

The treatment must depend upon many circum-
stances, such as the patient's age, general health
and habit of body, and mode of life. As a general
rule it must be general, or calculated to act on the
whole system, so as to induce a beneficial change
in its action. The alterative medicines are there-
fore most to be relied upon, as Mercury, Iodine,
and Sarsaparilla, and in cases of tonic debility Iron
must be administered. Attention to the diet, air,
and climate, are also of the greatest importance.
Consumptive people are always more or less liable
to this affection, and I am persuaded that in many
it exists sufficiently to impair the power of the
organ, and cause partial impotence when it does not
proceed to the suppurative stage.

DISEASES OF THE TESTES. 119

FOREIGN BODIES IN THE SCROTUM ALONG WITH THE
TESTICLES. •

Sometimes little round bodies like peas are found
in the Tunics, composed of firm Cartilaginous mat-
ter or bone. I have seen one as large as a marble,
and hard as ivory. It is seldom there are more
than three of them. The origin of these bodies can
only be conjectured, though they are probably only
diseased secretions, like those sometimes found in
the joints, which were first attached to the Tunics,
and then became loose.

Worms, Hydatids, and other living beings are
very rarely met with, though they have been occa-
sionally seen.

In some instances the Scrotum has contained the
remains of a Fcetus, which had evidently descended
from the Abdomen alon^ with the Testicle. M.
Velpeau communicated a case of this kind to the
Academy of Science in the year 1840, in which
he removed nearly all the parts of a Foetus from
the Scrotum of a man aged twenty-seven. The
patient had suffered from the enlargement from
birth, but its character was not suspected till M.
Velpeau performed the operation for its removal.

(To understand how this inclusion of one Foetus
in another can take place, the reader is referred to
" The Origin of Life," if he be curious in such
singular cases.)

NERVOUS AFFECTIONS OF THE TESTICLES.

The Testes, like other parts of the body, are sub-
ject to several kinds of nervous affections, which

120 DISEASES OF THE TESTES.

frequently cause exquisite misery, though they
may not. lead to any positive injury.

Irritable Testis. — This is a form of nervous dis-
ease in which the Testis is in a constant state of
peculiar uneasiness and irritation, rather than acute
pain, though sometimes it is more painful in one
particular spot. It is so exceedingly sensitive that
the touching of the dress, or the mere rubbing of
the Scrotum against the limbs, causes such distress-
ing annovance that the sufferer dislikes even to
move. Sometimes the irritation extends up the
cord, so that the movements of the bowels, or the
passage of urine, become exciting causes, and the
patient cannot even cough without an increase of
his misery taking place.

In some cases this morbid sensibility affects both
Testes, and in others only one, which is usually the
left. It does not appear to cause any alteration in
the parts nor swelling, except occasionally a little
fulness, particularly of the cord, and some relaxa-
tion of the Scrotum. It is seldom that an attack
passes off very soon, but more usually it lasts
several months, during which the sufferer loses all
relish for society, and almost all capability for en-
joyment in any form. All his thoughts are fixed
upon his sufferings, and the idea takes possession of
his mind that he will never be better, or that he
will be impotent or die of Cancer, and some request
their physicians to castrate them, to avoid these
dreaded evils.

The causes of this distressing affection are partly
constitutional, it being chief!)'' met with in those who
are naturally weak, irritable, and disinclined to
physical exertion, or in the hypochondrical and

DISEASES OF THE TESTES. 121

dyspeptic. It is however immediately produced, in
most cases, by some derangement of the genital
organs themselves, more especially such as are
brought on by masturbation, excessive indulgence,
or involuntary emissions. Young persons of a
nervous habit and strong sexual feelings, are also
liable to it while unmarried, and I have been con-
sulted in many such cases which could not be bene-
fitted by any kind of treatment till marriage took
place. In a modified form it is often experienced
about the period of puberty, in consequence of the
great and unusual activity of the organs at that
time, and much evil may result if a word of advice
and caution be not then given. The young person
will in all probability discover that a temporary
relief can be obtained by the vicious practice of
self-indulgence, and not knowing that this will
really increase the irritation, eventually, he goes
on with the practice till his health is seriously im-
paired and his sufferings aggravated almost beyond
endurance.

The treatment of irritable Testis depends in a
great measure upon the peculiar condition of the
patient, and the state of his general health. In
many cases it is so entirely of a nervous character
that we need merely advise a change of air and
scene, or cheerful company, or some interesting
mental occupation, in short, any thing that will
arouse the sufferer to activity, and turn his thoughts
away from his affection. If he be dyspeptic it is
essential that his digestive organs should be attended
to, and if he be costive, which is often the case, the
bowels must be brought to a more regular state
before improvement can even be hoped for. In
cases where there is great debility, tonics must be

11

122 DISEASES OF THE TESTES.

used, such as the Steel drops, or Peruvian hark, and
a generous diet must be advised, with a little wine.
The use of cold water externally is of the very first
importance, as it gives tone to the parts, and re-
moves the morbid sensibility, more perhaps than
any thing else. The parts should be freely bathed
with it two or three times a day if possible, or at
least night and morning. In obstinate cases a
plaster of Belladonna Ointment may be placed over
the whole Scrotum, or laudanum may be used as a
lotion. A good suspensory bandage is also very
frequently of great service.

In addition to any treatment, however, and still
more essential, is a knowledge of the cause of the
trouble. If any of the above named practices are
persisted in, or if the patient's situation in life is
unsuited to his temperament, no great good can
possibly result from medical treatment alone.
These things must therefore be spoken of, either to
the patient himself or to his guardians.

It is not necessary to perform castration for this
disease, as it is for some others, because it is
not a serious one, and generally either subsides of
itself in time or can be relieved by appropriate
treatment.

In one instance a gentleman was affected with
this morbid irritability, in one of his Testes, just
before the time appointed for his marriage, and was
so convinced that it was but the beginning of a
•greater evil, that in spite of all advice to the con-
trary he insisted upon having the organ removed,
which was done. Directly after, however, the
other began to be as irritable as the lost one had
been, but this of course he was not so desirous of
parting with, and therefore bore with the trouble.

DISEASES OF THE TESTES. 123

He was married and had no further trouble after-
wards. The removed Testicle was perfectly
healthy and sound.

Neuralgia of the Testes. — This is a nervous dis-
ease of a much more serious character than the one
already described, and more difficult to treat. It is
characterized by acute pains, sometimes lancinating
and at others dragging or pricking, which are
usually accompanied by spasms of the cremaster
muscles by which the Testes are drawn forcibly up
to the groin. In general these pains come on
periodically, as in other cases of Neuralgia, and
between the paroxysm the Testes are often per-
fectly free from pain, even when handled, though
there is occasionally a little morbid sensibility in
them, and perhaps a little soreness on the edge of
the hip-bone. The attack may last only a few
minutes or many hours, and is usually confined
to only one Testis ; some patients have it come on
twice a day, others once a day, and some again
only once in several days. Some are affected with
sickness and vomiting, and others with shiverings
and cold perspirations, while others again , expe-
rience such intense agony that they roll upon the
ground and groan, or perhaps faint away.

In nearly every instance when examinations
have been made of the Testes so affected, after their
removal, no alteration whatever has been detected
in their structure, nor any indication of disease to
which the neuralgia could be ascribed. In some
long-continued cases, where the pain has been
great, there has been a little swelling and inflam-
mation, but this is rare. ■

The causes of Neuralgia of the Testes are but
little known, or rather, perhaps, not known at all.

124 DISEASES OF THE TESTES.

It is met with at all ages, and in almost every
variety of constitution, though most frequently
attacking those who are subject to derangements of
the digestive organs. It very often appears to
result from some disease of the Testes, particularly
Orchitis, and from Varicocele, or disease of the
Kidneys. Many persons experience it from Gravel,
and still more from the passage of a stone from the
Kidneys to the Bladder. Gouty subjects are liable
to it, and so are those affected with enlargement of
the Prostate Gland.

In the treatment of Neuralgia of the Testes, the
first thing is to ascertain if there exists any other
disease, which may possibly cause it. The Diges-
tive Organs must be attended to, and the patient
must be advised to avoid all causes of mental dis-
quiet, or nervous agitation. Internal medication is
seldom of much use, though in some cases relief is
obtained by taking Iron, in various forms, particu-
larly the Pills of the Carbonate of Iron, and if the
attacks be regularly periodical, Quinine may be of
service, in doses of five grains, three or four times
a day. Turpentine is occasionally very efficacious,
in the following form :

R. The yolk of one Egg ; oil of Turpentine,
three drachms ; syrup of Orange-peel, and syrup
of Tolu, of each two ounces ; Laudanum, one
drachm.

These are all to be well mixed together, and
three table-spoonfuls to be taken daily.

Warm fomentations of hops, or poppy heads, will
sometimes benefit, but at other times ice-water will
be still better. A blister may be put upon the
Scrotum, if all other means fail, and a quarter of a
grain of Morphia placed on the raw surface. A

DISEASES OF THE TESTES. 125

Belladonna Plaster will sometimes relieve, or an
Ointment composed of one grain of Aconite to one
drachm of Lard, rubbed over the parts twice a day.
The Tincture of Aconite is sometimes still more
efficacious when rubbed on the Scrotum with a
sponge, and will often so numb the parts that no
pain will be felt for hours. Twenty or thirty drops
of Laudanum are sometimes beneficial, internally,
and the following preparation still oftener.

R. Extract of Hyoscyamus, five grains ; Acetate
of Morphia, half a grain ; to be taken twice a
day.

Neither bleeding nor Mercury appear to be of
any use in this disease, but Galvanism, properly ap-
plied, is frequently of great service.

When the disease is too severe to be borne, or
seriously affects the patient's health, if all other
means fail, Castration may be performed. It
should not be done prematurely, however, nor with-
out due consideration, for sometimes the disease
will subside spontaneously, after enduring a long
time, and even when the operation has been per-
formed the Neuralgia has often remained in the cord
as severe as ever. I have known the disease re-
main for two years, causing the most agonizing
suffering nearly the whole time, and then go off and
never return.

Several cases of this singular disease have lately
come under my care, and in no two of them has the
same treatment been beneficial. Each one has had
to be studied and prescribed for separately, but in
none was an operation necessary.

ir

126 DISEASES OF THE TESTES.

SPERMATOCELE, OR SWELLING OF THE TESTES FROM
ENGORGMENT OF SEMEN.

It. is very seldom that this affection is met with,
though it sometimes occurs from obstructions in the
Vas Deferens, and Urethra. It may also arise in
falling of the Cord, from its becoming twisted or
knotted, and from swelling of the prostate Gland,
causing pressure on the ejaculatory ducts. The
symptoms are swelling and heat in the Testes, with
a distinct sense of fulness in them and aching pain.
There is also usually considerable priapism, and
intensity of sexual desire, but not always.

The treatment consists first in removing all
causes of obstruction, if any exist, and then in cold
lotions and rest, with purgatives. Sometimes Sper-
matocele is met with as the simple result of undue
continence, but this is rare. The effects of it, if
long continued, may be inflammation of the Testicle,
with Hydrocele, and ultimately complete impotence.
If the means above directed do not give relief
Leeches may be applied to the perineum, or general
bleeding may be practised from the arm. The
diet should also be very spare and simple, and the
drink cold water. The mind must not be allowed
to be idle, nor the imagination too much excited,
and the body must be inured to regular and brisk
exercise in the open air. If, notwithstanding all
these, the trouble still continues, and threatens to be
serious, nature indicates but one more mode of
relief, which is sure to succeed. In very obstinate,
cases of Spermatocele, the pressure of the Semen
has been known to hurst the seminiferous Tubes,
and I am persuaded, from what I have seen, that it

DISEASES OF THE TESTES. 127

frequently injures the structure of the Testicle. I
once saw the testicles of a young man dissected who
died in an epileptic fit, brought on by an intense
struggle to suppress all sexual desire. They pre-
sented the most confirmed case of Spermatocele
perhaps ever seen, being engorged with semen till
much larger than the natural size, and evidently in
a state of chronic inflammation. The tubes were
blocked up with hardened semen, almost of the con-
sistence of cheese, and many of them were broken
and run together. In a short time the structure of
the organs would have been completely destroyed.
The Vas Deferens and Epididymis were also en-
gorged in the same manner, and in many parts
were beginning to change their structure.

SCROTOCELE OR RUPTURE OF THE INTESTINES OR
OMENTUM INTO THE SCROTUM.

To understand the nature of this affection it is
necessary to refer back to what has already been
stated. During Fcetal life the Testes are contained
in the Abdomen, from which they descend into the
Scrotum about the ninth month, by an opening
called the abdominal ring. After they have de-
scended this opening usually closes, and no further
direct communication then exists between the two
cavities. In some cases, however, this closing up
is not accomplished before birth, and then there is a
liability for the Intestines, or their covering the
Omentum, or both to descend after the Testes into
the Scrotum, forming a Scrotal Hernia. In most
cases this takes place very early, but it may be
delayed some months, or years, and has taken place
as late as the thirtieth year. The symptoms are

128 DISEASES OF THE TESTES.

much the same as those of other ruptures, except-
ing that the tumor is found in the Scrotum. If the
bowel is compressed in the ring till the passage in
it is obstructed, great suffering results, with inflam-
mation, and nearly certain death if relief is not
obtained. I have known infants suffer severely
from this trouble, and in fact be almost lost from it,
without any idea on the part of their parents as to
what they ailed. I have also known boys become
subject to it suddenly from leaping, or from strain-
ing of the bowels, and suffer the most dreadful
tortures before they told how they suffered, or
before any one found out what was wrong.

If the Rupture exists from birth the Testes cannot
be felt while it is down, because they are covered
by it, but when the Rupture occurs in after-life the
Testes can be felt behind, in the ■ lower part of the
Scrotum. In some cases the Hernia is small, and
descends only a small distance, so that no great in-
convenience is experienced, and it may exist in this
way for years, or even for life, but there is always
danger of its becoming worse. Occasionally a
quantity of fluid descends from the abdomen, either
with a Rupture or without, constituting a true Hy-
drocele, but differing from that occuring in after-
life by the fluid returning into the abdomen, when
pressed upwards. Children are sometimes born
with a large accumulation of fluid in this way, and
in others it appears a few days after birth. In
these cases the fluid also usually disappears into
the abdomen when the patient lies down, and may
be kept there when erect by pressing the finger on
the abdominal ring, but immediately the finger is
taken away it re-appears.

The treatment of Scrotal Hernia is much the

DISEASES OF THE TESTES. 129

same as that of other ruptures, and when properly-
conducted usually produces a cure, unless there is
some malformation of the parts that cannot be cor-
rected. The protruded parts are first pushed back
into the abdomen, leaving the Testes in their place,
and then a properly-constructed Truss is worn that
presses on the abdominal ring, to prevent their
return. If this be worn regulai'ly, and the parts
never allowed to fall again, the passage will gene-
rally close up, and the cure be thus made complete
in a few weeks. The older the patient is, however,
the longer time it will require to effect a cure, and
the greater chance there is that it may not take
place at all, in which case a Truss must be con-
stantly worn.

Great care is required in applying the Truss that
it does not press on the Intestine, or on the Testes,
for if it does so, great pain and perhaps inflamma-
tion may result. It must also be carefully ascer-
tained that the Testes are in the Scrotum, because
if they are not the truss will be improper, as it will
prevent their descent.

In Congenital Hydrocele the fluid may be kept
back, more or less completely, in the same way as
the Intestines, and in young persons it usually
absorbs in the course of time. In very bad cases
of Scrotal Hernia, when the Intestine is strangula-
ted, and cannot be replaced by external manipula-
tion, an operation is needed, which consists in
cutting the neck of the sac, or the ring, a little
larger, so as to allow of its return. This, however,
must always be performed by an experienced Sur-
geon, and in such hands is perfectly safe and com-
paratively easy.

Parents cannot be too careful in observing their

130 DISEASES OF THE TESTES.

children, so as to detect any trouble of this kind at
the earliest moment. From want of attention this
way a Scrotal Hernia may take place, and produce
serious effects, before anything of the kind is sus-
pected, and the proper treatment may thus be too
long neglected. A severe fit of crying is very
likely to bring this on, in infants who are disposed
to it, and hard coughing may do the same in after
years. It is very seldom cured, so as to do without
a truss, after puberty.

VARICOCELE AND CIRCOCELE, OR SWELLING OF THE
VEINS OF THE SCROTUM AND SPERMATIC CORD.

Varicocele is simply a swelling .of the veins on
the surface of the Scrotum, and is never of a serious
nature, unless caused by other diseases. It appears
to arise spontaneously in many cases, but more
frequently follows severe fatigue, long standing, or
debilitating diseases. All that is required is for the
patient to wear a suspensory bandage, use the cold
astringent lotions directed in Hydrocele, and rest.
If he be of a full habit of body it may also be
requisite to order a low diet for a time, and the
strict use of cold water as a drink.

Circocele is a swelling of the primary veins of
the spermatic cord, within the Scrotum, and may
become much more troublesome than Varicocele,
though it is but seldom serious. The swelling is
felt in the Scrotum like a firm knotty tumor, on one
side of the Testicle, and becomes larger when the
patient coughs or strains, but subsides when he lies
down. It is on this account that Circocele has
sometimes been mistaken for a rupture of the
Omentum into the Scrotum. It only needs a proper

DISEASES OF THE TESTES. 131

examination, however, to show the truth. When
tlic patient lies down push the tumor up into the
abdomen, and press the finger firmly on the abdo-
minal ring, then let him rise, and if it be a rupture
the tumor cannot descend again while the finger is
held there, but if it be a Circocele it re-appears im-
mediately.

It is seldom that anything more is experienced
than a sense of weight and uneasiness in the parts,
except in severe cases, and then there may be
pains in the back and loins, with weakness in the
thighs, and eventually a wasting of the Testicle.

The treatment must be almost precisely the same
as given for other swellings. Cold astringent
lotions, the suspensory bandage, purgatives, and
rest, by lying upon the back, is all that can be
generally advised, though there may be particular
circumstances in each case to indicate something
more. There are cases so severe as to require the
removal of the Testicle, but fortunately they are,
rare.

Many sufferers would escape this affliction if
they would wear a suspensory bandage in time,
when the swelling and inconvenience are first
observed, and many would have no return of it if
they did not leave off the supporter too soon.
The veins on the right side appear to be seldom
subject to swelling, nearly all the cases being on the
left side, though occasionally both are affected, but
the left always the most so. This is probably
owing to the position of the Colon, or lower part of
the large Intestine, which descends on the left side,
and by pressing on the veins prevents the blood from
freely returning, and thus causes the swelling
below. It is on this account that persons who suf-

132 DISEASES OF THE TESTES.

fer from Constipation are most liable to Varicocele,
and that it is always worse when the bowels have
been lon^ unmoved and are full. It is for the same
reason also that the left ovary, in females, is most
apt to be affected with Varicocele. Among other
general causes of this disease may be mentioned
excessive indulgence, Masturbation, Inflammation
of the Testicles, and Ruptures or Tumors in the
Abdomen. Very fat people are sometimes affected
with it, owing to the pressure of the fat in the lower
part of the abdomen, and those who wear trusses
are liable to it from the pressure of the instrument,
unless it be well made, and carefully adjusted.
Riding, hard running, leaping, and lifting will also
bring on swelled veins, and sometimes even burst
them, particularly if the Scrotum be much relaxed.
It is most frequent at the age of puberty, though
met with occasionally at other periods.

The characteristics of this disease are so clearly
marked that a mistake can seldom occur in regard
to it, the cord is plainly observed to be swelled, the
enlargement being greatest below, on the Testicle,
and on pressure it feels like a roll of knotted cords,
or a bunch of earth-worms. This swelling is
always greatest at night, or after exertion, and
from coughing or straining in any way. It may
also be reduced by lying down, and by the ap-
plication of cold. Many patients discover that it is
nearly always much better after coition, and they
are, therefore, apt to indulge frequently, under the
idea that it does them good. This, however, is a
great and fatal mistake, the temporary relief being
merely owing to the contraction of the Scrotum,
and to the increased speed of the circulation, which
always occur immediately after coition. As soon

DISEASES OF THE TESTES. 133

as this temporary excitement is over the relaxation
is greater than before, and the swelling of the veins
increases, as all those who have tried the experiment
well know.

In general, if taken early, the disease may be
readily checked by the means already described,
but if neglected it may become very severe and
obstinate, and sometimes gives rise to Neuralgic
symptoms. There is also danger of wasting of the
Testes, as before remarked, owing to the circula-
tion of the blood being impeded, and the usual
supply of nutriment being thus cut off. Many
instances of this kind are related in medical
works, and I have seen several myself. In some
cases the Testes will waste away, and almost
totally disappear, in a few months after the Vari-
cocele commences. This, of course, destroys all
sexual power arid feeling, and makes the patient an
eunuch. It is therefore advisable, if all the usual
means fail of arresting the swelling, and particu-
larly if wasting commences, to resort to some other
treatment, and several modes have been adopted by
different Surgeons with various success. Sir
Astley Cooper, and some others, used to cut away a
piece of the Scrotum, and then draw the parts
together and let them heal. This, of course, made
the Scrotum less, and by drawing the Testes firmly
up to the abdomen afforded a beneficial support to
the parts above. In many instances this operation
has effected a cure, but in others the relief from it
has been but slight. ' The disease has also re-
appeared, with all its former severity, many years
after being cured in this way. This operation is not
applicable to all cases of the disease, and even in
skilful hands is frequently attended by great danger.

12

134 DISEASES OF THE TESTES.

Besides this plan, some surgeons have cut through
the veins, or tied them, and sometimes even cut
part of them out. Of course either of these plans
leads to the destruction of the Testes, besides being
liable to cause inflammation of the veins, and other
serious results, and they are therefore very objec-
tionable though often successful in curing the Vari-
cocele. M. Delpech, a celebrated French surgeon,
operated upon a man in this way, and cured him,
but the Testes afterwards wasted away, and this
being unexpected, and undesired, the man was so
enraged that he assassinated the surgeon.

The only treatment that can effect a cure without
sacrificing the Testes is the application of pressure,
in such a way as to lessen the circulation of the
blood in the veins, without stopping it entirely.
This can sometimes be accomplished by a pecu-
liarly formed Truss, or bandage, and at other times
by a ring ; but the making and fitting of these
instruments is a matter of great difficulty, and re-
quires to be done for each case separately. I have
often had the pleasure of affording relief in this
way, but only after immense trouble on my own
part, and great perseverance and patience on the
part of the patient.

When nothing else can be done, castration must
be performed ; and our surgical records give us
many instances of this operation being resorted to.

HEMATOCELE, OR SWELLING OF THE SCROTUM AND

SPERMATIC CORD FROM* THE EFFUSION OF

BLOOD.

This affection differs from Hydrocele in being an
effusion of blood, instead of water, either into the

DISEASES OF THE TESTES. 135

Scrotum or spermatic cord. It is sometimes caused
in performing the operation for removing the fluid
in Hydrocele, by wounding one of the blood-vessels,
and thus allowing the blood to run into the cellular
Tissue or Tunica Vaginalis. It may also occur,
spontaneously, from the rupture of a branch of the
spermatic veins, and may result from blows or
sprains, the same as effusions of blood in other
parts of the body.

This accident is rare, and seldom serious. If
the patient keeps perfectly still, supports the Scro-
tum with a bandage, and uses fomentations of hops,
boiled in vinegar, or spirits of wine and water, or
vinegar and water, and keeps the bowels gently
relaxed, nothing more will in general be required.
Sometimes, however, the blood-vessel remains open,
the blood keeps flowing, and the swelling becomes
so large, and presses so much on the Testes that
great distress is experienced. In these cases an
incision must be made, the blood let out and the
vessel tied, unless it can be closed by pinching
it together externally, which may be done if the
place of rupture is discovered. If there be any
inflammation it must be combated by leeches, cold
lotions, and other usual remedies, and if it suppu-
rates a poultice must be applied.

PRURIGO, OR ITCHING OF THE SCROTUM.

This is one of those annoying complaints, which,
though not at all serious, are still sufficient to make
any one suffering from them completely miserable,
and even sometimes almost desirous of death, as the
only means of relief. The itching is sometimes
felt without there being any unusual appearances in

136 DISEASES OF THE TESTES.

the parts, but more frequently a number of roundish
red pimples are seen on the Scrotum, which, by the
patient scratching to relieve himself, often become
much enlarged, and highly inflamed. In long con-
tinued cases the skin becomes considerably thickened
and very hard, and a disagreeable discharge takes
place from the sebaceous glands. I have known
persons so tormented with this disease as to be
frequently delirious, and utterly unable to obtain
the slightest alleviation of their distress.

The real causes of Prurigo are entirely unknown
to us, but it is undoubtedly much aggravated, if not
brought on, in many instances, by want of proper
cleanliness. The plentiful and regular use of cold
water would prevent more of this trouble than any
kind of medication can ever cure. In many per-
sons the secretions of the parts are naturally very
acrid, and if not speedily removed they are sure to
irritate every spot they touch.

Old persons are most subject to this complaint,
though it occasionally attacks others, and it is
usually confined to the genitals exclusively, but
will sometimes extend down the inside of the thighs
and round the anus.

The treatment must be chiefly external, unless
there be habitual indigestion, or constipation, in
which case a few simple alteratives may be of ser-
vice. If constipation exists a little Epsom Salts
may be taken, and if the stomach be disordered Jive
grains of Plummer's Pill may be given every other
night, for five or six nights. The patient must be
particularly cautioned not to rub the parts, and his
dress should by no means be allowed to chafe them,
nor should it be too warm and close. Even at
night the bed-clothes must be light, and the bed

DISEASES OF THE TESTES. 137

itself hard and cool. But little exercise should be
taken, and that very gentle, and the parts should be
thoroughly washed twice a day with warm soap and
water. A cooling lotion may also be used during
the day, of Vinegar and Water, with a little Lauda-
num, or what is often better, two grains of Bichloride
of Mercury to two ounces of water. Equal parts of
Citrine Ointment and fresh lard also forms an excel-
lent application to be rubbed well over the parts at
night. Sulphur Ointment benefits in some cases,
and a Sulphur Vapor Bath still more so in others.
It is especially important that the diet should be
simple, light, and unstimulating, and that no
alcoholic or fermented liquors should be taken.

Sometimes the itching arises from the presence
of certain peculiar little parasitic animals, in which
case they may be readily destroyed by rubbing on
a little of the white precipitate powder occasionally.
In fact this may also be used with a prospect of
benefit whenever the skin is not much broken.

ELEPHANTIASIS SCROTI.

This terrible disease is fortunately extremely
rare in this part of the world, and it is only neces-
sary to describe it in order to complete our treatise.
It appears in the form of a peculiar swelling of the
Scrotum, caused by the infiltration into its integu-
ments of a jelly-like albuminous fluid, which
accumulates in some cases to a most enormous
extent. The outer surface of the skin appears
rough and chopped, or covered with large brown
scales, so that it has somewhat the appearance of an
elephant's foot. Sometimes, but not very fre-
quently, a number of ulcers are formed, and the

12*

138 DISEASES OF THE TESTES.

chapped places discharge an offensive sanious
secretion.

This disease is chiefly confined to Barbadoes,
though found in others of the West India Islands,
and also in Egypt, Africa, Greece, and the East
Indies.

The size of the Scrotum is sometimes almost past
belief, and yet in some of the very worst cases the*
patients enjoy excellent health, without any disturb-
ance of the functions of other parts of the system,
which shows that the disease is purely local. Mr.
Liston removed one of these Tumors which weighed
forty 'pounds, which had been nineteen years
growing ! M. Delpech remoyed one that weighed
sixty pounds ; and Baron Larrey saw one in Egypt
that weighed over a hundred pounds. Instances
have even been known of their weighing over two
hundred pounds, and sometimes even the patients
have been able to sit upon them, like a seat. Very
often they hang down to the ankles, and are four or
five feet in circumference. There is no cure for
this affection, so far as yet known, and the only
remedy is to remove it with the knife, which has
frequently been done with perfect success/ Dr.
Picton of New Orleans, removed one of these
Tumors from the Scrotum of a negro, in 1837,
which weighed fifty-three pounds, and had been
growing for ten years. Much larger ones have,
however, been removed, and sometimes even with-
out destroying, or in any way injuring the genital
organs, so that the patient has been as well and
perfect afterwards as ever he was before. It is,
however, extremely difficult to preserve the geni-
tals, and generally they have to be removed along
with the diseased mass. The great danger is from

DISEASES OF THE TESTES. 139

loss of blood, and from this many of those operated
upon have died. A Chinese named Hoo Loo came
over to London to be operated upon for this disease,
and Mr. Key removed the tumor, which weighed
fifty-six pounds, but the poor man died from loss
of blood.

FALLING OF THE SPERMATIC CORD.

From various causes the sheath of the cord is
liable to become excessively relaxed, and weakened
in its attachments, so that it falls down more or less
into the scrotum. This is indicated by a sense of
weight and fulness in the scrotum, and by dull
pains in the groin, with uneasiness in the testicle.
On examination a kind of knotty tumor is felt just
over the testicle, or down on one side of it, which
may be gradually pushed up into the abdomen, and
which draws up itself to a great extent when the
person lies down. This tumor is the cord, which
has fallen in a heap and presses on the testes. In the
morning it is seldom to be seen, except very slightly,
but usually re-appears when the patient has been
on his feet a short time. It is also worse in hot
weather, and after great fatigue, or much nervous
agitation. Straining from constipation will also
tend to bring it down worse, and so will sexual
excesses.

This is simply a local weakness, but it may
nevertheless lead to very unpleasant consequences
if allowed to continue unchecked. The constant
pressure on the testes becomes very painful, and
may lead to inflammation, or hydrocele, and ulti-
mately the cord may form false attachments and
grow fast in its wrong position, so that no means

140 DISEASES OF THE TESTES.

can afterwards remove it. The treatment is simple,
but requires perseverance. The parts must be
regularly bathed with cold astringent washes, such
as alum water and solution of sugar of lead. This
must be done at least morning and night, and if pos-
sible two or three times during the day, the fluid
being washed up the groin, and under the perineum
as well as on the scrotum. The dress must not
be too warm between the limbs, and no lifting or
straining must be practised. As little standing as
possible is also advisable, and constipation must be
particularly avoided. — The most essential requisite,
however, is a suspensory bandage, or in very bad
cases a truss, made to press on the abdominal ring.
Both these instruments should be put on before the
patient rises in the morning.

Falling of the cord usually results either from
general debility, straining, sexual excesses, or
fatigue upon the feet. It may occur only on one
side or on both.

RELAXATION OF THE SCROTUM.

This affection is something like Falling of the
spermatic cord, being produced by similar causes,
and requiring similar treatment. It results from a
weakness in the fibres of the dartos and great cre-
master muscle, owing to which the weight of the
testes pulls down the scrotum and elongates it,
sometimes to a great extent. In some men I have
known it hang, when they had been long upon their
feet, full six inches below the pubes. Besides the in-
convenience of the falling itself, it is nearly certain,
if it continues too long, to bring on falling of the
cord, and probably hydrocele. It always causes

DISEASES OF THE TESTES. 141

an annoying sensation of weight and dragging, with
more or less pain in the groin, and weakness in the
limbs.

The only treatment required is the regular use
of cold astringent washes, as directed in falling of
the spermatic cord, with the constant wearing of a
suspensory bandage. The same precaution must
also be observed as to regulating the bowels, and
avoiding excesses and fatigue. — If cold water and
the suspensory bandage were resorted to in time,
and perseveringly, neither of these affections would
scarcely ever become very bad, unless from sudden
straining. — Sometimes however it is caused by un-
usual weight in the testes, from swelling, tumors or
hydrocele, and of course can be removed only with
the cause producing it.

DISEASES OF THE VASA DEFERENTIA.

The Vas Deferens is only a small Tube, and is
liable to several accidents that will impede the
proper performance of its functions.

It is not unfrequent after a recovery from Hydro-
cele, or Hernia Humoralis, for the Vas Deferens to
become partially obstructed, or even totally oblitera-
ted, owing to its having partaken of the inflamma-
tion, and its walls having in consequence grown
together. When the obliteration is complete the
individual is of course sterile, because there is no
passage for the semen. The Testicle may be per-
fect in its action, but the semen cannot leave it, and
this not only produces sterility, but sometimes leads
to fatal inflammation of the Testicles from their
being constantly overcharged with semen, and un-
able to relieve themselves. When there is only a

142 DISEASES OF THE TESTES.

partial obstruction the patient experiences a singu-
lar difficulty in the evacuation of the semen, which
is effected very .slowly, and often with great pain.
In some of these cases the orgasm will be over and the
erection gone down before the semen begins to flow,
and then it comes in drops for a considerable time,
causing great inconvenience and annoyance.

Unfortunately we know of no remedy for this dif-
ficulty when it has long existed, but when it is only
a temporary result of acute inflammation it is of
course only necessary to subdue that to give relief.
The great point is to prevent such an accident, by
checking all inflammatory action in the Testes and
other parts, which lead to it, before the Vas Defe-
rens becomes affected. It is mostly caused by
neglecting Hydrocele and Hernia Humoralis too
long, or by improperly treating them, though it
may also be brought about by blows over the groin.
A temporary obstruction of the Vas Deferens often
arises from its being pressed upon by a swelled
vein, or by tumors in the Testicle and groin, in
which case it is of course relieved only when such
cause is removed. It is advisable to let such causes
exist as little time as possible, because the retention
of the semen may injure the Testicle. I have
known an improperly-constructed truss press on the
spermatic cord and close the Vas Deferens, so that
the person was quite sterile while he wore it.

Sometimes the Vas Deferens becomes Dilated, or
Relaxed, so that its size is much increased and it
nearly or quite loses the power of retaining the
semen, or become so full of it as to produce incon-
venience. The causes of this trouble are unknown,
though it most probably results from retaining the
semen when it is nearly ready to flow as often as

DISEASES OF THE TESTES. 143

from any other cause. I have known men afflicted
in this way who habitually tried to prevent the flow
continuing, from a mistaken idea that if they could
lessen the discharge they would not be so much
weakened by coition. It is scarcely necessary to
say that such practices do not lessen the discharge,
but merely make it finish afterwards in an unseen
and dangerous form.

It is not easy to ascertain when the Vas Deferens
is enlarged or relaxed, but when there is good
reason to suppose it is so the treatment is simple.
Cold lotions of Alum-water or Suo;ar of Lead, as
recommended in former articles, must be constantly
used, or ice may be frequently applied so as to
astringe the parts, and all improper habits must be
immediately abandoned.

In addition to these, the Vas Deferens is liable to
several other affections, as Scrofula and Tumors
for instance, which are, however, very rarely seen,
and as their treatment in no way differs from that
of the same affection in other parts, they do not
require any special notice. In some few cases the
Vas Deferens has been totally absent from birth,
while the Testes and other organs were perfect. In
this state the Semen is formed, erection even occurs,
but there is no emission, because there is no passage
from the Testes. This condition of the parts is
nearly sure to lead to Orchitis, or Spermatocele,
•from the irritation of the retained Semen, unless the
patients desires are weak, or kept much under
control. If the Vas Deferens of an animal be cut
out, or tied, it is found that the Testicle still secretes
the Semen, though it cannot escape, showing that
the power of secretion is not lost by the impossi-
bility of emission.

144 DISEASES OF THE TESTES.

DISEASES OF THE SEMINAL VESICLES.

The precise use of these two organs is yet a
matter of dispute among physiologists, some regard-
ing them as real Glands, by which a peculiar liquor
is secreted to mix with the Semen, while others
look upon them as mere reservoirs in which the
Semen accumulates previous to its emission. When
dried and injected the Vesicles are seen to be two
Tubes convoluted and turned upon each other so
closely that their parts look like cells. The ends
of these Tubes open into the Vas Deferens, just
where the ejaculatory duct commences.

It appears certain that the Vesicles have con-
siderable contractile powers, and this has favored
the idea of their being intended to contain the
Semen and afterwards eject it during coition.
When examined after death, however, they do not
contain Semen, but are filled with a yellowish fluid
apparently peculiar to themselves. Their precise
use is therefore as yet unknown.

They appear to be subject to obstruction and
obliteration like the Vas Deferens, but we have no
means of detecting such derangements, nor can we
propose any remedy. •

145

CHAPTER V.

THE STRUCTURE, DISEASES AND MALFORMA-
TIONS OF THE PENTS AND THE PARTS
IMMEDIATELY UONNECTED WITH IT

The Penis is a hollow spongy organ down which
runs the passage from the bladder, called the
Urethra, by which the urine escapes, which also
serves for the exit of the semen, as before ex-
plained.

The Anatomical structure of this organ is not
thoroughly understood by Anatomists, owing to the
difficulty which necessarily exists of dissecting it
in its several states. Sufficient, however, is known
to explain its Physiological action, which is all we
now require to' know.

The body of the. Penis consists of two distinct
parts, each of which is very porous, or rather
spongy. The upper part, which is the largest, is
called the Corpus Cavernosum ; the under part,
which is much the same in its structure, is called
the Corpus Spongiosum. Both parts extend from
the Pelvic Bones to the Glans at the end. The
Corpus Cavernosum is divided down the middle
into two parts, by a septum, or partition, and some
physiologists on that account speak of two Caver-
nous bodies, or the Corpora Cavernosa ; it is, how-
ever, strictly but one. These two parts are rounded
on the under edge, so that when they come flat
together there is a groove formed underneath, and'
in this groove lies the Urethra. They are both
firmly attached to the front bones of the Pelvis,

146

PLATE X.

Fig. 1. The Bladder and Penis laid open.

a. The inside of the Bladder. — b. b. The Ureters, or
Tubes which convey the Urine from the Kidneys to the
Bladder. — c. c. — The Vasa Deferentia. — d. d. The
mouths of the Ureters. — e. The Prostate Gland.— -f.
The Veru Montanum. — g. Openings of the Seminal
Ducts.— h. The Ischio Cavernous Muscles, which assist
in erection. — i. i. The bulb of the Urethra. — k. k. Cow-
pers Glands. — 7. The wide part of the Urethra. — m. The
narrow part. — n. The second wide part, called the Fos-
sa Navicularis. — o. The Glans. — p. The Prepuce. — q.
The Meatus Urinarius, or external opening of the
Urethra. *

The Cellular, or spongy structure of the body of the
Penis is shown on one side, like a honey-comb ; and the
distribution of its blood-vessels on the other.

Fig. 2. Cross Section of the Penis.

a. a. The Corpus Cavernosum. — b. The division or septum
between the two parts of the Corpus Cavernosum. — c.
The Corpus Spongiosum. — d. The Urethra. — e. The great
Vein of the Penis.

FIG. I. FIG. n.

Plate X.

Section of Penis and Bladder.

DISEASES OF THE PENIS. 149

under the Perineum, by two roots called the Crura
Penis.

The Corpus Spongiosum surrounds the Canal of
the Urethra underneath, and fills up the remainder
of the groove, so as to round the whole organ. It
terminates posteriorly in what is called the Bulb of
the Urethra.

The whole organ is surrounded by the skin, ex-
cepting the end, where we find a body called the
Glans Penis, which is both different and separate
from either of those described. The inner fold of
the skin of the Penis is attached to the termination
of the Corpus Cavernosum, while the outer fold is
extended beyond, so that it only partly covers the
Glans but is not attached to it, and may be drawn
back. This loose skin is called the prepuce, or
foreskin, and is the part cut off in the rite of cir-
cumcision* In some persons it extends farther over
the Glans than it does in others, but generally
leaves more or less of it exposed. The Glans is
probably an enlargement of the peculiar erectile
tissue surrounding the. Urethra, and is covered by
a highly sensitive and vascular skin, of an exceed-
ingly delicate structure. It is in the form of a sec-
tion of a cone, and terminates on the posterior or
upper margin by an elevated ridge, called the Corona
Glandis, behind which is a depression called the
Cervia, or Neck. In this depression are several
glands called the Glandula Odorifera, which produce
a whitish secretion, of a peculiar odor, that some-
times accumulates in great quantities in those who
neglect proper cleanliness. On the under side of
the glans the prepuce is attached nearly at the end,
by a fold, or ligament, called the Franum, or Liga-
mentum Prceputii. This ligament, or cord, is some.

13*

150 DISEASES OF THE PENIS.

times too short, and during erection is so pulled
upon as to cause great annoyance ; occasionally it
even ruptures, or tears, causing severe pain, with
loss of blood.

These parts constitute the substance of the Penis,
and are therefore most essential to the performance
of its proper functions.

The peculiarity of the structure of the Corpus
Cavernosum and of the Corpus Spongiosum, consists
in their being full of curiously arranged blood ves-
sels and cells, or cavities, like those of sponge, all
communicating with each other, and being con-
nected with the main branches of an artery and a
vein. In ordinary states these vessels, excepting
the larger ones, and also the cells, are nearly or
quite empty, but under appropriate excitement the
blood from the artery is impelled into them and fills
them up, in consequence of which the organ en-
larges, like a sponge when filled with water. This
is called the Phenomenon of Erection, and it depends
upon a peculiar sensibility proper to the parts, which
are therefore sometimes spoken of as being composed
of Erectile Tissue. There is no other part of the
body that in any way resembles the Penis in
structure, except the Clitoris in the female, which
has a similar Tissue, and is usually capable of
erection to a certain extent, in precisely the same
way.

When the excitement is withdrawn the blood or-
dinarily flows back by way of the cavernosus vein,
and the erection subsides, but sometimes its return
is prevented, and the erection then remains, though
all excitement has gone. — The Corpus Spongiosum
is so distinct from the Corpus Cavernosum that erec-
tion will sometimes take place in one and not in the

DISEASES OF THE PENIS. 151

other, which necessarily curves the organ, or draws
it into the form of a bow, producing what is termed
a chordee. The erection, and emission of semen,
is also assisted by a number of different muscles,
particularly by one called the Erector Penis, or
Ischio Cavernosas Muscle. Sometimes in erection
the rush of blood will be so sudden and violent that
the vessels will burst, and the erectile tissue be thus
totally destroyed. In some persons the filling up
of the blood-vessels always occurs in a very short
time, while in others it is the reverse ; and in like
manner the erection subsides in a short time in some,
while in others it will continue for a long period
and subside very slowly. This depends upon some
peculiarity in the vital action of the blood-vessels,
not yet understood. In old age the blood generally
flows in slower, and flows out much quicker than it
does in youth, so that the erection is longer in taking
place and goes down more rapidly.

The uses of the Penis, as before remarked, are
two-fold, firstly it serves as a conduit, to convey the
urine from the body, and secondly as a conductor
to carry the semen into the female organs. For
the first use erection is not necessary, but it is for
the second, and therefore its proper occurrence is
both natural, and essential to the performance of
one of the functions of our nature.

The form of this organ varies in different ani-
mals, for the purpose of adaptation, and is some-
times very singular. In some it is covered with
spines, so as to give great pain to the female during
connexion, as in the cat, while in others its structure
causes that act to be much lengthened, as in the
dog. In birds the male organ is merely rudiment-
ary, so that there is no actual union, properly speak-

152 DISEASES OF THE PENIS.

ing, but merely an emission into the female organs.
In the human being there are occasional deviations
from the ordinary development, and sometimes even
peculiarities in structure. Thus instances have
been known of the interior of the Corpus Caverno-
sum being more or less ossified, so that a distinct
bone always existed in the middle of the organ.
This is often the case in negroes, and in some of the
lower animals it is natural. In a few rare instances
the penis has been found double, or rather divided
into two parts, only one of which of course contains
a urethra, though both may be capable of erection,
as I observed in one 'case in my own practice.
Probably amputation of the imperfect part might
have been safely effected, but as little incon-
venience was experienced it was not thought
necessary.

The various peculiarities of structure and deve-
lopment that interfere with the functions of this
part will be treated under appropriate heads as we
proceed.

ABSENCE AND MALFORMATION OF THE PENIS.

Besides being liable to be lost by several acci-
dents, and by necessary operations, the Penis may
also be deficient from birth. I have seen instances
when it was not more than a quarter of an inch in
length, and sometimes only a slight swelling, like
the top of a small tumor. In such cases of course
there can be no connexion, but still such men may
be fathers, providing all the other parts are perfect,
because, as before explained, the semen may im-
pregnate if it be only shed within the external lips,
which may of course be effected in the worst of

DISEASES OF THE PENIS. 153

these instances. I have known instances of married
couples, with families, who never had any associa-
tion, from similar causes. It is unnecessary to say
however that marriage should never take place in
such cases without the nature of the infirmity being
first known, though I believe the law would declare
any marriage binding if impregnation was possible.
In giving an opinion under such circumstances it is
however difficult to decide this point. In general,
in healthy females, the placing of the semen artifi-
cially in the vagina will induce conception, but not
always. Hunter relates an instance where he ad-
vised the injection of the semen with a syringe, after
its escape from the husband, and impregnation fol-
lowed. There are some females, however, in whom
its absorption will not take place without a certain
amount of excitement, dependent upon actual asso-
ciation, so that there will always be more or less
uncertainty, and much less probability than when
no such deprivation exists. Independent of this,
however, there are other considerations that should
forbid the marrying of men so situated, unless t with
a full knowledge of the circumstance and its conse-
quences by both. In some of these cases, especially
when a portion of the organ is left, as after opera-
tions and accidents, the difficulty may be much
remedied by an instrument, so constructed as to fit
on the part remaining, and resembling that which
is lost. I have known instances of conception fol-
lowing the use of such an instrument, when the
penis itself was not more than a quarter of an inch
long. But then the semen was formed in great
quantities, and was remarkably healthy.

In some children the Penis is tied down to the
Scrotum, or some other of the neighboring parts, by

154 DISEASES OF THE PEINS.

bands, which never allow it to be extended, and of
course prevent the performance of its functions. I
saw one child of seven years in whom it grew flat
on the Abdomen, causing great trouble and annoy-
ance in urinating from the direction in which the
fluid had to flow. Nearly all such cases can be
easily corrected by a slight operation at any age,
the adhesion being usually only by the skin, but are
better attended to early in life. The one referred
to was put right very readily, and in two years'
time scarcely a trace of the operation could be
seen.

Occasionally the Penis will have a wrong direc-
tion, being turned so much either on one side,
under, or upwards, that association is impossible.
If this depends upon contraction of the skin, or of
the muscular fibres, it may be corrected by simply
dividing them, but if it results from a tumor, or
swelling, that must be removed before any altera-
tion can be effected. Aneurisms, and swellings of
the veins, will, sometimes bring about such devia-
tions, and so will too long continued erection, by
rupturing some of the cells or vessels, and so
causing accumulation of blood. I knew one in-
stance of this kind in which every time erection
occurred a large tumor was formed on the left side
full of blood, which of course turned the end of
the organ to the right side, and thus prevented con-
nexion. This accident had been caused by numer-
ous forcible and long-continued erections in one
night, during intoxication. The tumor was as
large as an egg, and when full could be distinctly
felt to pulsate. It was also very painful, and ap-
peared almost ready to burst. The remedies pro-
posed were cold astringent lotions and wearing a

DISEASES OF THE PENIS. 155

thin flat plate of smooth horn over the part, bound
on so firmly as to prevent any swelling from
accumulation of blood. This plan succeeded very
well in giving relief, though it is probable there
will always be more or less tendency to a recur-
rence of the trouble.

Besides Scrofulous and other. Tumors in the
Penis there will sometimes be bony swellings, and
accumulations like calculi or stone in the bladder.
These may either compress the Urethra, and so
prevent the passage of the Urine and Semen, or
they may curve the organ so as to prevent its use ;
in general, however, they can be removed.

Sometimes the Frsenum or cord that binds down
the prepuce at the end underneath, will be so short
or contracted that during evacation the point of the
Glans will be pulled under. This not only prevents
the Semen being thrown straight forward, but even
prevents connexion in many instances, either caus-
ing severe pain, or by bending the end of the organ
so much. This difficulty is easily remedied, by
cutting through the cord with a pair of scissors, or
a lancet. I advised a gentleman out West how to
do this, in a letter, and he wrote afterwards to in-
form me that he had succeeded perfectly, with his
razor. It is simply necessary to take care to cut
only deep enough to just sever the cord, and after-
wards to keep the parts stretched asunder, so that
they do not grow together again ; a simple dressing
of cloths dipt in cold water is all that is required
after. I have known the cord to be eaten through
with caustic, but the plan is not so good as cutting,
being more tedious and painful, and leaving a larger
scar. In some persons it has been broken suddenly
during a violent erection, or on attempting coition,

156 DISEASES OF THE PENIS.

but such accidents are always painful, and are bet-
ter avoided by a timely operation.

HYPOSPADIAS.

This term means a case where the end of the
Urethra does not come to the end of the Penis, but
opens underneath, the passage not reaching the
whole length of the organ. This state of things
sometimes follows severe venereal cases, and other
accidents, but its causes when congenital are of
course unknown to us, and unfortunately but little
success generally attends its treatment.

This malformation is a cause of great trouble
and annoyance in urinating, and interferes more or
less with the power of impregnating, though it by
no means prevents it altogether, as was formerly
supposed.

Sometimes the opening is close by the Frsenum,
and during erection it is firmly olosed, owing to the
pressure, so that the Semen cannot escape from the
Urethra. In such cases there cannot be impregna-
tion, unless the Semen flows after the erection has
somewhat subsided, but this it will not always do,
because it may run backwards into the bladder, and
in such cases the patient is necessarily impotent.

When the Semen escapes freely, providing it be
within the female organ, conception may or may
not take place, according to circumstances, let the
opening be where it may.

At other times the opening is so near the .body
that the Semen, when it does escape, cannot enter
the female organs. In such cases the only resort
left is artificial impregnation, as before explained.

The nearer the opening is to the end of the Penis,

DISEASES OF THE PENIS. 157

generally speaking, the more chance there is of
success, and the nearer it is to the body the less.
In some situations any kind of treatment is out of
the question. When it is close to the body the
Urine and Semen run down the Scrotum or Peri-
neum, unless an instrument be worn to prevent it,
causing constant irritation and annoyance.

Sometimes there are two openings, but they sel-
dom communicate, and the fluids nearly always
escape by one only.

It was formerly considered, even by the most
eminent surgeons, that it was impossible to operate
with any prospect of success in these cases, from
the nature of the parts, and from the constant flow of
Urine ; they therefore advised to leave them alone,
and provide the sufferer with the best, remedial
instruments, to lessen the inconvenience. In
modern times, however, success has attended
numerous attempts to correct this malformation,
and under favorable circumstances it is always
attempted.

The mode of operation is simply to pass a small
sharp-pointed instrument straight through the Penis,
along where the natural opening should be, and
thus make an artificial passage, which is kept open
by bougies till the cut edges have healed and there
is no danger of it growing up again. When this
is fully accomplished a catheter is introduced, and
the edges of the old opening underneath are made
raw and held together, by needles or other con-
trivances, till they adhere, and thus the opening is
closed. In this way a new passage is formed in
the proper direction, and the old unnatural one is
permanently obliterated. There are, however,
many circumstances that may make the success of

14

158 DISEASES OF THE PENIS.

the operation very uncertain, and some that may
forbid it being attempted.

In general the proper canal of the urethra ex-
ists, but in a small state, and is closed only at the
very end, by a thick membrane. This membrane
may usually be easily cut through and the canal
enlarged by bougies, by which means, if the false
opening can be closed, a perfect cure can be ob-
tained. Sometimes however there is no trace of
the urethra, and the passage has to be cut through
the solid flesh the whole distance, which is apt to
excite so much inflammation that no bougie can be
worn, and then all grows up again. The false
opening is also so large in some cases," or the edges
are so thin, that it cannot be closed, and then the
new opening may be of little use, though it be formed.
In some of these cases, however, a small tube can be
worn internally, extending just past the opening
underneath, so as to conduct the semen and urine
to the proper opening at the end ; or a piece of gum
elastic, or oiled silk, may be worn firmly over the
opening externally, to effect the same object. By
such means many a sufferer has been enabled to
urinate in comfort, in the natural way, and many
an impotent man has become a father.

Instances have been known where the false open-
ing was between the Testicles, or even in the Peri-
neum, and yet it has been perfectly closed and a
new one made the whole length of the Penis. Such
operations, however, require great skill in the sur-
geon and much endurance in the patient.

In many instances, when the false opening is
near the end of the Penis, it will be found that the
proper passage is continued the whole length of the
organ and merely closed at the mouth by a skin.

DISEASES OF THE PENIS. 159

I knew a man who was troubled in this way, the
opening being just at the base of the glans, who
could close it with his finger and send the urine
along the natural passage till it made the skin at
the end project. Having heard me explain about
this in some of my Lectures he determined to try
and operate himself; accordingly he took the sharp
end of a penknife and where the skin projected
strongly he made a small puncture very readily,
through which the urine escaped immediately.
The inflammation soon subsided and the new open-
ing remained, so that by always closing the old one
with his finger he could urinate as well as if nothing
was wrong. I told him that the old opening could
be easily closed permanently, by another slight ope-
ration, but he felt so well content with what was
already done, and suffered so little inconvenience,
that he would not consent to anything further.

One of the greatest difficulties is in keeping a
catheter in sufficiently long to make the urine flow
down the new passage while the old opening grows
together. Very often the .place will be nearly
closed, and then a rush of urine will come and
break it open, destroying all that had been done.
In old cases also the edges are apt to be very thin
and ragged, and the orifice large, so that a perfect
junction is next to impossible. If there is any scro-
fulous tendency also the probability of its ever clos-
ing is very small. In many of these cases, as in
external abscess of the Prostate Gland, the wound
may be perfectly healed for a time, but break out
again without any apparent reason.

Many of these deformities can be corrected in
infancy, or early youth, and they should therefore
be always shown to experienced surgeons imme-

160 DISEASES OF THE PENIS.

diately they are detected, and not concealed, as they
are by some parents. — It is difficult to say to what
age success is possible in such cases, probably
there is no particular limit ; some have been ope-
rated upon at thirty, and others even at forty, or
more, but the earlier the better. — In general the
development of the Penis is more or less imperfect
above the false opening, and when the full genera-
tive power is desirable this must also be corrected,
by means which I will explain in another article.
Sometimes it is even necessary to effect this deve-
lopment before the operation can be performed.

EPISPADIAS.

This affection is precisely the reverse of the
former, the false opening being on the top of the
Penis instead of underneath. It is much more rare
than Hypospadias, and is somewhat more difficult
to treat, owing to the opening being farther from the
natural passage. The orifice will sometimes be
near the end and sometimes close by the Pubic bone,
occasionally being a little on one side.

The mode of operation is exactly the same as in
Hypospadias, but as before remarked, it is more dif-
cult and the chances of success are less.

PHYMOSIS.

In this malformation the skin of the prepuce comes
completely over the Glans, and the opening at the
end is so contracted that it can never be drawn back.
This condition of the organ, is both unpleasant,
annoying, and dangerous, because it prevents proper
cleanliness, and thus disposes to various diseases.

DISEASES OF THE PENIS. 161

The secretion of the Glandulse Odorifera is apt to
accumulate under the skin, and in conjunction with
the urine to create serious inflammation. Calculi
will also form, like those in the bladder, and the
swelling will sometimes be so great that neither
semen nor urine can pass. In many cases of Phy-
mosis the swelling is so great as to cause severe
pain during erection, and the Glans is so compressed
in consequence, that the semen cannot escape, and
thus the individual is impotent.

The means of giving relief are very simple. It
is only necessary to introduce an instrument care-
fully under the skin and cut up the Prepuce, so as
to let it open. This may be done with but little
trouble or pain, and with slight danger from inflam-
mation if a simple dressing of cold water be applied.
It is sometimes necessary to cut off the edges of the
wound a little with scissors, particularly if they are
anyways callous, or ragged. The whole prepuce
is at times so hard and unyielding that it becomes
necessary to practise complete circumcision.

PARArHYMOSIS.

In this case the prepuce is drawn back, over
the Corona Glandis, compressing the organ like a
tightly, drawn cord. In some it is permanently in
this situation, while in others the patient has drawn
it over the Glans and has not been able to slip it
back again, owing to the smallness of the opening
and the swelling of the parts. When it results from
this cause it will often be sufficient to use cold lo-
tions for a time, to reduce the swelling, and lubri-
cate the parts with some Belladonna Ointment, when
the prepuce may be drawn over without difficulty.

14*

162 DISEASES OF THE PENIS.

Sometimes a little bleeding may be necessary, or a
few leeches on some of the neighboring parts.

The only certain cure is to cut the Prepuce,
in the same way as for Phymosis, which will of
course prevent any return of the difficulty. Pa-
tients with Phymosis are very apt to change that
trouble into Paraphymosis by their attempts to draw
the Prepuce back, and to stretch it.

In young children both these states may exist
without causing any great annoyance, but as they
approach puberty serious trouble may be expe-
rienced suddenly. It is, therefore, very necessary
for parents to observe such accidents, and watch
their progress, particularly near puberty, so that the
Surgeon may be applied to in time. Many a man
has suffered for life, both physically and morally,
from neglect of this kind while he was a child.

I once knew an instance of a youth who had a
permanent Paraphymosis that had never caused him
any trouble till he was about twelve years old,
when it began to pain him whenever he urinated,
and later, when erection occurred, severely. When
about fourteen years of age, in consequence of
some unusual irritation, the parts swelled very
much, and the Prepuce was drawn so tightly around
that the Glans was perfectly strangulated. Not
being in the habit of speaking about such matters
to his parents he concealed it till the agony was so
great he could hold out no longer. On a physician
being sent for it was found that the parts had begun
to gangrene, and the urine had been retained so
long that inflammation of the bladder had also
supervened. By prompt treatment the most urgent
symptoms were alleviated, and after a time the
Prepuce was cut through, so as to give permanent

DISEASES OF THE PENIS. 163

relief. The patient, however, came very near
losing the organ itself, if not his life, through want
of a proper confidence and habit of communication
between him and his parents.

Both Phymosis and Paraphymosis may result
from the inflammation attendant upon other diseases,
particularly those of a venereal or syphiloid cha-
racter, and then iU is usually only required to
remove the primary affection to give relief, though
sometimes the operation is needed.

It is necessary to state here that many a child has
become addicted to Masturbation, and has perished
in consequence, simply from having a neglected
Phymosis ; the secretion accumulating under the
skin, causing constant irritation and leading to mani-
pulations that would not otherwise be thought of.

I have known many men operate upon themselves,
and successfully too, for both these affections ; a
penknife, or pair of scissors, being the only instru-
ment used. No cutting should, however, be prac-
tised on these parts when there is venereal disease,
because the wound may innoculate, and thus the
disease be spread.

In some persons the Prepuce is absent altogether,
and attempts have been made, under such circum-
stances, to form a new one, by bringing forward
the skin below, but no great success has attended
the operation, nor is it at all essential. The only
reason given for desiring it is that the Glans is apt
to lose part of its sensibility when constantly un-
covered, which is undoubtedly the case, as may be
seen amonsr Jews and others who have been cir-
cumscised ; but this a slight inconvenience, even if
it is not often an advantage, as it certainly makes
the person less liable to contract disease.

164 DISEASES OF THE PENIS.

WANT OF DEVELOPMENT, OR CONGENITAL SMALL
SIZE OF THE PENIS.

It is sometimes difficult to say whether the Penis
is too short or not, because there is no precise stan-
dard of limitation, and in different people the
development varies very much* In some persons it
never grows from the condition in which we find it
in childhood, while in others it will attain a medium
size, and in others again it will be nearly rudimen-
tary. This may also be totally independent of any
deficiency in the other organs, though most usually
they correspond more or less. Thus I have seen a
man of forty years of age in whom. the Penis was
only two inches long, and about as thick as the little
finger, but whose Testes were of a full average
size, and who had strong sexual feelings, with a full
flow of Semen. Sometimes the organ can scarcely
be traced at all, being merely like a wart, or small
tumor.

When the non-development of the Penis is depen-
dent upon a general torpor of the genital organs,
more especially of the Testes, their action must be
aroused, and their functions fully established, in the
manner pointed out in the chapter on the Testes. If
this can be done the Penis may be made to grow
even to an advanced period of life, as I have there
shown.

In those cases in which the Penis alone is not
sufficiently developed a different treatment is re-
quired, as it is simply a local effect we wish to
produce. In some of these instances the organ,
though small, is capable of perfect erection, and
both connexion and impregnation may be effected

DISEASES OF THE PENIS. 165

by its means ; it is not then a matter of such urgent
moment for, any improvement to be effected, though
under certain circumstances it may be desirable.
More frequently, however, erection either does not
take place at all, or so imperfectly that coition is
impossible, and the flow of Semen is so imperfect
and irregular that impregnation can seldom be
effected, even artifically. Under such circum-
stances it is a matter of the greatest consequence to
produce an increased development, so that both
these functions may be performed, and it may be
both new and pleasing, to many persons, to learn
that there are means by which this desirable end
may be often attained, even under the most un-
promising circumstances. It is proper to remark,
however, that the cases now referred to are those in
which the small size is congenital, or existing from
birth, and not those in which the organ has
decreased, from disease or excess, after having been
of average development, though even in many
of them, when the constitutional stamina is not too
much impaired, the same means will frequently
restore what has been temporarily lost.

The causes that prevent the proper development
of this organ, as well as of others, are of course
unknown in those cases that are congenital, because
they operate before birth, but in those that become
arrested during childhood or youth, we generally
trace it to early masturbation, blows on the Tes-
ticles and other accidents, or to some severe disease
which has impaired the vital energy very much.
Some diseases are particularly apt to affect young
persons in this way, as the Mumps for instance,
which often make the Testes swell.

Scarlet Fever and Measles, when severe, I have

166 DISEASES OF THE PENIS.

known to seriously injure the virile power, but not
so frequently as rickets or scrofula.

A similar deficiency is sometimes found in
females, in some the Uterus or Ovaries being very
small, though the Vagina may be large enough to
allow of coition, while in others these organs will
be of usual size, but the Vagina will be too small,
so that marriage is not allowable. In my work on
" The Diseases of Woman," I refer to such cases,
and explain what can be done to relieve them.

To effect an enlargement of the Penis, in addition
to every means proper to improve the general health,
and impart stamina, there are certain mechanical
and manual applications, the effects of which, under
right direction, are often of the most unexpected
and pleasing character. To understand the nature
of these, and their mode of action, it is necessary
to bear in mind the anatomical structure of the or-
gan, and the requisites for erection. That pheno-
menon, it will be recollected from our previous de-
scription, depends essentially upon the filling up of
the vessels and cells of the spongy and cavernous
bodies with blood, and of course if there be any
fault in their make or mode of connexion, or if the
blood does not flow into them, erection cannot take
place. Now this is precisely the fault that is found
to exist iii most of the cases of non-development
above referred to, and is what requires to be cor-
rected. On dissecting such cases after death we
find that the cells and minute vessels have never
been congested or filled with blood, and conse-
quently the organ has never been able to grow nor
become erected. In the same way after long conti-
nued excess, or debilitating disease, the artery seems
to lose its power of transmitting the blood with suffi-

DISEASES OF THE PENIS. 167

cient vigor, and the cells, from want of being filled,
decrease in size, and eventually grow up more or
less, causing the organ to shrink. This is the rea-
son also why absolute suppression of sexual excite-
ment, if continued too long, will make the organ
waste away, instead of increasing its power, as
many uninformed people suppose.

The object to be accomplished it will be seen is to
open these cells, and cause the blood to flow into them,
so as gradually to increase their size and dispose
them to fill spontaneously, from natural excitement.

In some persons, who have always shunned all
thoughts of sexual matters, from a notion that they
are improper, it is sometimes sufficient merely to
encourage such thoughts to a proper extent, and the
excitement this gives rise to in the parts will act
favorably on their growth. In others the daily em-
ployment of a warm local bath, with brisk rubbing,
and the use of a stimulating ointment, which I shall
hereafter describe, will be found still more effica-
cious ; and if this treatment be regularly persisted
in, under judicious direction, combined with proper
internal remedies, it will succeed in a large number
of the cases ordinarily met with. It is requisite,
however, that the external and internal stimulants
should be exactly apportioned to the wants and ca-
pabilities of the individual's system, and that a strict
watch should be kept upon the action and effects of
each, so as to know when to increase or decrease
their power, and when to suspend their action alto-
gether. Until over forty years of age, if the form
of the organ is perfect, and its development not too
small, a considerable change may be effected in this
way, though the younger the patient is the more
readily the parts are acted upon.

168 DISEASES OF THE PENIS.

I once had a patient call upon me from Cuba, the
son of a rich planter, who was troubled with this
imperfection, and who was intensely desirous that it
might be remedied so as to allow of marriage. — He
was about twenty-three years of age, and of a strong
robust' habit of body, with excellent health. On
examination the Penis was found about two inches
and a half in length, and about as thick as the fore-
finger, properly formed, but with little more sensibi-
lity than any other part of the body. The Testicles
were fully developed, and the sexual feeling was
quite strong. There had been frequent emissions
of semen, under strong excitement, but no erection,
and consequently no connexion could take place. —
Upon enquiry I found that he had been brought up
to a very rigid code of morals, and had imbibed
certain notions about -the necessity of not indulging
sexual desires, if the mind was wished to become
powerful, and as he was very ambitious of distinc-
tion he made a perfect anchorite of himself. The
bodily effect of such a course has been seen, — its
effect on the mind was to make him wayward, irri-
table and unhappy. A short time before he came
on to see me he met with a young lady with whom
he fell violently in love, and immediately the desire
for marriage arose, but with it came the fear that
he was totally incapacitated. The new desire, so
strongly awakened, together with the fears he felt,
operated so intensely upon him that he became
almost furiously insane. On assuring him, how-
ever, that there was a reasonable prospect of his
attaining a more perfect state he became calmer,
and patiently submitted himself to the prescribed
treatment.

The first object was to induce as much heat as

DISEASES OF THE PENIS. 169

possible in the organ, so as to promote the flow of
blood to it. This was accomplished by the use of a
hot stimulating lotion, two or three times a day, fol-
lowed by brisk rubbing with flannel and soft brushes.
In three weeks the effect of this treatment became
obvious, — erections occured, partial at first, but
ultimately quite forcible, and the organ evidently
began to increase permanently in size. In addition
to this he was directed to use some stimulant drops,
and to live generously, to impart as much vigor as
possible to the Generative Organs. The flow of
semen soon became much larger than before under
this treatment, and the procreative instinct much
more powerful. There was still one fault, however,
and that was a want of power in the muscles that
assist in erection and coition, more especially in the
Erector Penis muscle. This was remedied by fre-
quent shampooing, and pressing of their fibres till they
acquired volume and firmness, the same as any
other muscle would do under similar treatment.

This system was rigidly pursued for six months
under my own inspection, at the end of which time
the Penis was four inches long, when erect, and quite
firm, so that coition was possible. At this period
he was desirous to return home, and as he was
evidently determined to pursue the same treatment
himself, I consented to his doing so, though I would
have preferred for him to have staid still longer. [
heard from him eleven months after his departure,
and he then informed me that the improvement had
still continued till he no longer thought it necessary
to proceed. He was then intending to marry in
about three months. The delight and gratitude of
this young man were unbounded, rescued as he was
from the very depths of despondency and despair,

15

170 DISEASES OF THE PENIS.

and raised, as he expressed it, " to the highest pitch
of human happiness."

■ In the course of my practice I have had numer-
ous similar cases, some of them resulting satis-
factorily from the same treatment, and others
requiring a different plan, which I will now explain.
When the means above described fail to induce a
sufficient flow of blood into the erectile Tissue an
instrument is employed, called a Congester. It
consists of a Tube, the size of which is adapted to
the organ, to which is fitted an exhausting Air-
Pump. The Penis being introduced into this the
air is more or less exhausted, and the blood of
course flows into the contained part immediately.
So great is the rush of blood, in fact, that if the ex-
haustion was continued too far, or made too sud-
denly, the Tissue would burst. In a short time,
with care, the part begins to swell and look red, and
erection, more or less complete, soon takes place.
This never fails, unless the vitality of the part be
totally gone, or the structure of the Tissues com-
pletely disorganized. I have seen some of the most
remarkable results follow from the use of this in-
strument that were perhaps ever witnessed, in a
medical way. I have known patients in whom the
whole organ was not half an inch long, and without
the slightest tendency to erection, and yet the Con-
gester has caused it to grow, and has given it
power, until perfectly capable for the purposes
it was intended for. Sometimes there only appears
a simple protuberance, like a Tumor, while at other
times the organ is long but surprisingly small, and
quite flaccid, but still the Congester will impel the
blood into the Tissues and produce the effect de-
sired. Sometimes, it is true, we cannot gain so

DISEASES OF THE PENIS. 171

much as would be desirable, but nearly always suf-
ficient for Nature's requirements, and very often as
perfect in condition as if no imperfection had ever
existed.

In conjunction with the Congester it is* also
requisite, in most cases, to act upon the muscles, by
shampooing, as they are usually deficient in power,
and without their action the Penis cannot erect,
though it may become firmly congested.

This practice of shampooing the Perineal and
Genital Muscles, to improve the erectile power, was
originated in Asia, but has been known and prac-
tised in Europe for many years. The process is
both tedious and somewhat painful, and requires
both skill and knowledge in the operation. In
Turkey men make a regular business of this, and
they succeed admirably. In this country it is
necessary to direct the patient himself, or hired
assistants, and the constant supervision of the medi-
cal man is therefore required. To perform this
operation to advantage, it is best to have the parts
made perfectly bare and smooth, and then lubrica-
ted with a proper ointment. The operator then
presses the end of the fore-finger firmly into the
muscle, passing it along backwards and forwards,
in the direction of the fibres, till the muscle
becomes hot and swells. This is done with all the
muscles whose action is required, and it should be
practised every day till the effect is manifest. At
first the shampooing causes considerable pain and
soreness, but this soon passes away, and then
the muscle feels firm to the touch, and is found
to be much larger. There are two men in
New York whom I have had occasion to employ
for this purpose with so many patients that they

172 DISEASES OF THE PENIS.

have become quite expert, and I can always de-
pend upon success from their efforts when it is
possible.

It must be recollected that the various means I
have»d escribed require a long period to be put fully
in operation, and are such as can be commanded only
by those who have plenty of both time and money
at their disposal.

With those who are fortunately so situated as
to have these essential requisites the gain is cer-
tainly great and well worth what it costs, and I
have never known one who was successfully treated
who did not say he thought no price could be dear
to pay. Many a man has been saved from insanity
or suicide by these means, and many a domestic
hearth has been made the scene of happiness and
delight that was previously the abode of recrimina-
tion and despair.

I have treated patients of all ages, from mere
j^ouths up to mature age ; the oldest I recollect
being about fifty-two, and in most of them with a
success that has been as pleasing to them as it was
gratifying to myself. Some of the means I have
mentioned are scarcely known in this country,
and are certainly not put into general practice ; the
account I have given of them may, therefore, be the
means of giving many sufferers the first intimation
that help can be had. In some fictitious works
on these subjects, pretending to be written by emi-
nent men, but really made up only for sale, such
things are partially referred to, but in such a way
as to be of no real utility. In one of these an
account is given of many drugs, said to be proper
to use in cases of debility, some of which are
highly dangerous, and many of which do not exist

DISEASES OF THE PENIS. 173

at all. The present book is, I believe, the only one
on these subjects that is really scientific, as well as
popular.

One of the most remarkable cases I ever treated
was that of a young man of nineteen, who was
brought to me by his father, himself a physician.
In this person there was scarcely any appearance
of a Penis, but only a small Tumor, not projecting
more than a quarter of an inch, in the centre of
which was the opening of the Urethra. It was
quite sensitive, however, and seemed rather as if
compressed downwards. The Testes were of
average size, and the semen secreted in sufficient
quantity, occasionally, so that little seemed wanting
but the small organ. I at once told his father that
I felt assured much improvement could be ob-
tained, but that it would require much time and
attention, with great endurance on the part of the
patient himself. They were both delighted to hear
this, and the young man testified his desire that I
should commence the treatment immediately, which
I did. A Congester was constructed specially for
the case, and applied daily. The lower part was
of glass, so that its operation could be seen, and it
was observed that immediately the tube was ex-
hausted of air the Penis seemed to be drawn for-
ward, and extended to full two inches. The patient
complained of great pain in the part during the
operation, from the rush of blood into, the cells, and
it remained exceedingly tender for several days
after. The Congester was not applied again till
this soreness had subsided, but in the meantime the
stimulating hot lotions were used, and shampooing
of the muscles was practised. It was observed
that even the first application had evidently caused

15*

174 DISEASES OF THE PENIS.

some protrusion, and the young man remarked that
the internal sensations were different from what he
had ever before experienced. The internal medica-
tion in his case was of a more stimulating charac-
ter than ordinary because the sexual impulse was
not very strong, and only occasionally manifested.
His diet was directed to be as nourishing as possi-
ble, with wine for drink, and every day he rode out
on horseback after a warm bath, followed by brisk
rubbing of the whole surface of the body. After
the first effect had subsided the Congester was used
daily, and followed by the shampooing, for ten
weeks, by which time a permanent advance had
been made. The Penis measured full two inches
in its ordinary state, and in the Congester was ex-
tended to three. Partial erections occurred at times
during 'sleep, and the procreative instinct became
more active and permanent. I then directed him
to return home for three months, and only continue
the general treatment, so that I might see if Nature
herself could complete the work. At the end of
three months he came back to me with a still further
improvement, though slight. He was then put
under the old treatment again, and this time the
effects were still more satisfactory. In two months,
under the Congester, the Penis measured four
inches, and in the ordinary state remained perma-
nently at three, with firm erections and copious
emissions of semen. Finding, therefore, that every
requirement of Nature could «be fulfilled even as he
was, and that further improvement would evidently
take place with the growth of the system, I desisted
from further treatment and sent him home cured.
His father was as much astonished as gratified, and
another physician who had seen him and pronounced

DISEASES OF THE PENIS. 175

him a Hermaphrodite, would scarcely believe it was
the same being.

Another case was that of a man who had married
at thirty-two, though imperfect, from a mistaken
idea that marriage would effect a cure. The result
may be imagined ; the misery of two human beings
could scarcely be more complete. In his despair a
friend brought him to me for my opinion. On ex-
amination I found the Penis not very small, nor in
any way imperfect, but it had never been erected,
and seemed incapable of being so. The semen was
secreted plentifully enough, and the instinct was as
strong as was desirable. I told him without any
hesitation that he could be made perfect enough for
his marital duties in a short time, providing he
would follow strictly my directions, and submit to
my treatment, which he was willing enough to do.
The Congester was applied, and with the happiest
results. At the third application a powerful erec-
tion was produced that did not subside for a con-
siderable time, owing to want of perfect action in
the cavernous veins. This, however, was soon
remedied, and in two weeks, by the use of the Con-
gester alone, natural erections occurred spontane-
ously, as perfect as could be desired. In a word he
was perfectly cured, and is now the father of two
children.

I have also had numerous instances of persons
who had lost the power of erection from sexual and
other excesses, from mental anxiety and from the
effect of debilitating disease. In a great portion of
these the result has also been favorable, though in
many all vitality had left the organs before I saw
them, and in others the structure was completely
disorganized. Many young men especially, vie-

176 DISEASES OF THE PENIS.

tims of Masturbation, whose organs had ceased
growing, have by these means been rescued from
impotency and imperfection. Many a man of ma-
ture age also, whose powers were unimpaired, but
who could not exercise them, owing to this particu-
lar debility, has been restored to his former capa-
bility in the same way.

The Congester is not an instrument adapted for
self-treatment, and I would not advise any one to
attempt its use without proper directions and super-
vision. I have known it to do great mischief with
inexperienced people, and fail of accomplishing any
good. In one man who had it applied too forcibly
and suddenly the cells were nearly all ruptured, or
broken into one another, so that severe inflammation
was produced, and the power of erection was for
ever lost by any means.

There are some means, however, that all persons
may use, provided they know when they are appro-
priate to the case. The pressing and shampooing
may be partially practised by the patient himself,
though very imperfectly, but the general directions
as to diet and exercise may be observed of course
by all. Perhaps, however, there is no other
functional disability so difficult to treat, or that
requires so much skill and such unremitting • at-
tention.

In addition to the means already described there
are some others occasionally useful, but which are
not so generally applicable. Galvanism is some-
times an excellent agent, when there is nervous in-
sensibility combined with the other disabilities. A
very good mode to use it is to galvanize the metallic
congester, while the organ is engaged within it.
The power must not be too great however, nor the

DISEASES OF THE PENIS. 177

application continued too long, or there will be par-
tial paralysis.

The French have a practice of Flagellation,
which is sometimes very efficacious, and will induce
erection in a short time. It is rather severe, how-
ever, and few have courage or endurance suffi-
cient to continue it long enough to derive full bene-
fit. The Flagellator is made of six or eight small
twisted thongs, about as thick as a violin string, but
very flexible, and about eight inches long. To ope-
rate with it to the best advantage the parts should
be made bare, and perfectly smooth, and the Fla-
gellator must then be applied the whole length of
the Penis, and on the Pubes, Perineum, and inside
of the thighs, till the flesh is quite red and smarts.
The flogging must never be so hard, or long conti-
nued, as to make any bruises, nor leave any soreness,
but merely sufficient to make it red and feel hot,
with slight smarting. Usually about a quarter of
an hour is sufficient, every day. — After the flagella-
tion the parts should be well bathed in hot water,
and the patient should recline.

This treatment may seem singular to those who
nerer heard of it before, but it is undoubtedly more
efficacious, in numerous cases, than any one could
well believe who had not seen it practised. I have
known many patients resort to it with the happiest
results, who could not stay with me long enough for
the usual treatment. — In some it will produce pow-
erful erections the first time, and lead to an influx
of blood to the parts that soon stimulates their
growth.

Firing is another practice that may be resorted to,
if all others fail, for rousing the dormant energies
of these parts in deficient growth. — It consists in

178 DISEASES OF THE PENIS.

turning the parts with a smooth iron button, made
hot by plunging it in boiling water. The parts are
first made smooth and then the button is taken out
of the water and pressed suddenly on, repeating it
as fast as possible, till the whole length of the organ
has been operated upon. No part should be touched
twice, nor should the iron remain on more than an
instant. The pain is very slight, and no blister is
raised, the places only turning white at first, and
afterwards remaining red.— The firings should be
repeated only at intervals of three or four days,
waiting till the effects of one are gone off before
anojther is practised.

This process is sometimes astonishingly effective,
a single application producing such a powerful effect
that no further treatment is required. — Care is re-
quired, however, not to produce too much inflamma-
tion, nor to operate too near the Testes. Sometimes
the development will be much less on one side of
the Penis than the other, or less in the Corpus Spon-
giosum than the Cavernosum, so that the organ will
not be straight but curved ; or it may be straight in
the ordinary state but not capable of erecting in all
parts alike. This state of permanent chordee is
perhaps better treated by the flagellation or firing
than by any other means, because they can be ap-
plied locally, and only to the affected part.

It may perhaps be as well to remark here that a
modification of the congester is sometimes of great
service in certain torpid states of the female organs,
and that some of the other treatment is also occa-
sionally applied to them, in a modified form, with
the happiest results.

DISEASES OF THE PENIS. 179

PARALYSIS OF THE MUSCLES OF THE PENIS.

I first observed this affection in the person of a
patient, aged about fifty-three, having previously
seen no account of it whatever. Since then I have
met with other cases in persons of different ages,
though ahva3^s past thirty. In the first case it was
apparently the forerunner of general Paralysis, an
attack of which was experienced some two months
later, but partially recovered from. In other cases
I have also regarded it as a sign that general
Paralysis or Apoplexy was threatened, though it
did not always immediately follow.

In this disease the secretion of the semen is not
affected, nor is the flow of blood interfered with,
the organ becoming as full and as firm as before,
but there is no power to raise and direct it. The
first case yielded in the course of a week to Galva-
nism, and some others were alleviated by warm
baths and stimulant lotions, but others again re-
mained notwithstanding all that could be done.
These were mostly old people, with an obvious pre-
disposition to Paralysis. In some cases I have had
reason to think that the attack was brought on by
previous sexual excesses.

PRIAPISM, OR INVOLUNTARY ERECTION.

By this term is meant an unnatural and involun-
tary erection of the Penis. In some persons it
occurs only at intervals, but in others it is constant
for a long time and constitutes a real state of dis-
ease. Priapism is not always accompainied by
pleasurable feelings, though it usually is, but on

180 DISEASES OF THE PENIS.

the contrary it is sometimes painful. In some per-
sons it comes on suddenly, without any premonitory
symptoms whatever, but in others it commences
gradually, and is frequently indicated by a sense of
fulness in the Testes, or of pain and heaviness in
the head. The patient is utterly unable to control
the erection in the slightest degree, nor in general
can he by an means prevent it while the morbid
state continues. I have known men who always
suffered from this immediately they went to bed, so
that their rest was much disturbed. In one young
man especially the health suffered seriously. Every
night when he had been in bed about an hour the
Priapism would commence, and such was the effect
on his nervous system that sleep was out of the
question, while it continued. Very often for seve-
ral nights together he did not sleep more than a
single hour, and yet there was in general but little
sexual feeling, and that only at first, the sensation
afterwards being merely one of intense and harrow-
ing excitement. The next day he suffered from
headache, pain and weakness in the back, and sore-
ness in the organ itself. In no instance did he have
emissions during these attacks, and this is a pecu-
liarity I have frequently, observed.

The causes of this troublesome affection may be
various, and sometimes can only be surmised. In
many cases, especially among young persons in
vigorous health and of perfect development, it
results from an actual excess of semen, which first
causes Spermatocele, and then leads to a chronic in-
flammatory condition, by which the erection is con-
stantly excited. This condition may exist in those
who are not at all disposed to lascivious thoughts,
and even in those who are constantly striving

DISEASES OF THE PENIS. 181

against them, though it is of course made much
worse by indulging such thoughts. Most common-
ly in these persons the Priapism continues till an
involuntary emission takes place, and then it disap-
pears for a short time, till the semen has again
accumulated in too great Quantity. There are
some, however, in whom th*se emissions never oc-
cur, and in them the Prapism is frequently a
constant state and become eventually a real dis-
ease. In the early stage- marriage is of course the
only certain and effectual remedy, though much
mitigation may be effected by means that will here-
after be pointed out ; but when the organs have
become diseased or chronically inflamed, marriage
would be highly improper till a healthy condition is
restored.

It is not always the case, however, that Priapism
results from semipal accumulation, or superabun-
dant energy, for <t is sometimes experienced by
those that are rattier deficient, or at least below the
average. I have even observed it in those that
were nearly sterile. In these cases it is induced by
a diseased condition of the brain, and is usually
considered a mere moral affection, though like
many other moral affections it is simply an indication
and consequence of physical disease. In this state
there is constant desire at first, sometimes amount-
ing to furious erotomania, but eventually all feeling
and desire will vanish, while the Priapism will
remain, and sometimes even continue after death.
Long-continued debauchery is also sometimes fol-
lowed by obstinate Priapism, and eventually by
absolute impotency. In the Medical Repository for
April, 1824, is a case of this kind communicated by
Mr. Callaway. The patient, during a fit of in-

16

182 DISEASES OF THE PENIS.

toxication associated with a female three times in
succession, having emission each time, but no sub-
sidence of the erection, a circumstance which I
have often known to occur during- intoxication. To
ms great surprise the erection still continued the
next morning, and it remained for sixteen days, in
spite of all the means used to reduce it. The surgeon
then made an incision with the lancet, just below
the Scrotum, and immediately there escaped a large
quantity of thick black blood, mixed with clots.
On pressing the Penis the blood all flowed out of it,
by the opening, and it immediately became flaccid.
The man was impotent, however, afterwards, for no
erection ever took place again, owing probably to
the cells of the Corpus Cavernosum and Corpus
Spongiosum having grown up, from inflammation.
The continued erection was probably owing, in this
£ase, to inflammation at the lower part of the Penis,
or in the Perineal Muscles, owing to which the
'Veins were so pressed upon that the blood could not
return by them, or perhaps the veins themselves were
swollen and closed up. Some men have brought
on a similar condition of the parts by keeping them-
•selves too long excited, without allowing emission
•to take place, a practice which is very reprehensi-
ble, and which not unfrequently causes Spermato-
cele, or even Orchitis.

If the erection be too powerful, or too long con-
tinued, it will often cause temporary impotence by
so compressing the Urethra that the semen cannot
traverse along it. When this occurs the semen
either escapes afterwards, slowly, or else mixes
with the Urine.

Long continued priapism is always hurtful, and
is very likely to destroy the power of erection alto-

DISEASES OF THE PENIS. 183

gether, ultimately ; it is, therefore, desirable that
we should know its various causes, and the best
means of treating it. Persons who are not properly
informed respecting its nature are apt to consider it
as simply a result of loose thoughts, and that only
a proper effort is required to overcome it. This is
a great mistake, as we have already shown, and one
which leads both to the neglect of proper treatment
and also to uncharitable judgments.

In addition to the general causes of this affection,
already enumerated, there are also several others
that have a tendency more or less to originate or
aggravate it. Want of proper cleanliness, hot
clothing, particularly if it chafes, and the too fre-
quent use of warm baths may be mentioned, and
also several other diseases, such as gonorrhoea and
spermatorrhoea. The Gravel and inflammation of
the bladder also excite the penis very much in some
persons, and the piles will do the same in others.
Stimulating and highly-seasoned food, and hot or
vinous drinks have the same tendency, and sleeping
in a very warm soft bed is apt to assist. The use
of bougies and injections will often produce pria-
pism, and certain medicines still more frequently.
Cantharides, Phosphorus, and Opium, perhaps act
the most energetically in this way, but there are
others whose effects are very decided, and they all
act very differently at times and upon different per-
sons.— The reading of lascivious books, or listening
to loose conversation undoubtedly operates in a simi-
lar manner to these physical agents, and the indul-
gence of lying in bed in a morning, half awake, has
the same tendency.

The treatment of priapism must of course be regu-
lated by the cause that produces or aggravates it.

184 DISEASES OF THE PENIS.

When it is mainly produced by a want of properly
regulating the mind, or controlling the desires, the
cure must depend entirely upon the individual's
own self, or rather upon his strength of mind.
When it arises from a too stimulating diet and
drink, aided by a deficiency of muscular exercise,
which is very often the case in young persons,
nothing more is required than to live low, drink
cold water, keep the bowets free, and bathe the parts
frequently with cold water. If there be a too great
secretion of semen, with no sufficient involuntary
discharge, marriage is indicated. If there be any
other disease that must first be cured, and if there
be heat and pain in the head, particularly in the
back part, it must be frequently bathed in cold
water, and kept cool, precisely the same as for in-
flammation of the brain, of which in fact the pria-
pism is only a symptom. During the paroxysm the
parts may be bathed with warm Water or a warm
Enema may be given. Sitting in a warm bath is
sometimes the best plan, or over hot steam. In ob-
stinate cases Leeches may be applied to the Penis,
or a vein may be opened in it, but one of the best
remedies is to give sufficient Tartar Emetic to cause
sickness ; this generally relieves the priapism.
Two ordinary sized pills of Gum Camphor have
been found efficacious in some persons, and simple
fasting, till faintness ensued, in others. When the
paroxysm is over strict attention must be paid to the
diet, clothing and general conduct, as before indi-
cated, to prevent a recurrence.

I have had some patients with whom I have had
to use various mechanical contrivances, to prevent
the priapism occurring at night, or while the cura-
tive means were being employed. A simple band-

DISEASES OF THE PENIS. 185

age, drawn tightly round the organ when flaccid,
will often prevent the erection, but a better plan is
to use two grooved pieces of wood, one of which
must be placed above the penis and the other below,
so that they can be drawn together by a band, or
screw. The organ can be compressed so tightly
by this machine, while in its ordinary state, that
erection cannot possibly take place. Several of
my patients were unable to sleep till provided with
an instrument of this kind.

The longest period I ever knew an attack of pria-
pism to last was six weeks, and that was in a mar-
ried man. It first began during a short absence
from home, and was kept up by the impossibility
which he experienced, on his return, of discharging
the semen, owing to the swollen and inflamed state
of the parts. He suffered from spermatocele, and
slightly from orchitis, and was further troubled by
violent desire, which he was unable to gratify.
Connexion was possible, but without emission, and
consequently without gratification. I was much
afraid, from the violence of the attack, and from the
symptoms, that permanent impotence would follow,
but by careful treatment, perseveringly attended to,
be completely recovered.

I knew one instance in which priapism followed
a blow on the head, from which the person died,
and it remained after his death, the parts being so
firmly congested, and so rigid, that nothing had any
effect upon them. — In several instances I have
known priapism follow the application of blisters to
the neck and back, even in young children, a fact
that should not be lost sight of, either by physicians
or parents.

16*

186 DISEASES OF THE PENIS.

DISEASES OF THE URETHRA AND THE PARTS CON-
TAINED THEREIN.

The Urethra, as before explained, is a long canal
passing from the bladder down the penis, for the
purpose of conveying the urine out of the body, and
also for conducting the semen, it being the common
passage for both fluids.

The membranous walls of the Urethra are rather
thick, and are elastic, and the interior is lined with
a mucous coat similar to that inside the bladder.
The size of the urethra is different in different parts,
thus a little way in from the external opening, or
meatus urinarius, it expands considerably, and then
contracting again expands still larger at about two-
thirds of its length down. The substance of which
the walls of the urethra are composed appears not
to be the same in its whole length, being membra-
nous in some parts and in others spongy, almost like
the Corpus Spongiosum. It therefore participates
in the act of erection, and its concurrence is very
essential to the proper emission of the semen. Where
it first opens at the neck of the bladder it is wide,
but drawn together by certain muscles, excepting
when the urine is evacuated, when the muscles
relax and allow it to open. It is not by the drawing
together of the walls of the urethra alone, however,
that the urine is prevented from escaping, but partly
by the presence of the Veru Montanum. By refer-
ring to the plate of the situation of the male organs
the position of this part will be readily understood.
It is a small fleshy protuberance placed on the lower
wall of the urethra, just where it opens from the
bladder. In shape it is like a cone, with the small

DISEASES OF THE PENIS. 187

end pointing towards the end of the Penis. The
neck of the bladder closes around this little protu-
berance while the urine is retained, but during eva-
cuation it relaxes and opens a little and the fluid
then passes on each side of the Montanum, which
thus acts a similar part to the stopper of a bottle.
Many cases of incontinence of urine arise from
irritation of the Veru Montanum, which becomes
so tender that the neck of the bladder is kept con-
stantly open to prevent pressure upon it. This
irritation may arise from various causes, but most
usually we can only guess what they are. The
mode of subduing it is simply to use general means
for subduing- inflammation, such as are suitable for
all the neighboring parts. An irritating quality of
the urine is very apt to give rise to it, particularly
when very acid, and then it is readily corrected by
taking a little Carbonate of Soda every morning
before breakfast, and drinking freely of gum arabic
water. — I had one patient who suffered terribly from
this cause, without knowing, till explained to him,
what it was. Immediately the smallest portion of
urine was secreted in the bladder it felt as if a
piece of red hot iron was placed in the neck, and
all command over it was instantly lost, the urine
escaping in spite of all his efforts. The smarting,
burning, and pricking sensation he described as most
horribly torturing, without there being any appa-
rent possibility of relief. He had been told by some
practitioner that it was stone in the bladder, but I
felt assured, after careful examination, that it was
inflammation of the Veru Montanum, and advised
him accordingly. I prescribed hot fomentations of
Poppy Heads, on the pubes and perineum, with
Leeches also on the Perineum, and inside the

188 DISEASES OF THE PENIS.

Thighs. Internally I directed him to take the fol-
lowing powders with a dose of Castor Oil every
evening, and to drink plentifully during the day of
Barley Water.

R. Dried Leaves of Uva XJrsi, or Bearberry, one
and a half drachms ; Bicarbonate of Soda, one
drachm.

To be mixed together well, and divided into
tivelve powders, one of which to be taken three times
a day, in the Barley-water.

The effect of this treatment was evident on the
second day, the inflammation having subsided con-
siderably, and by the third day he was quite well,
with the exception of a little soreness when urinat-
ing.

Inflammation of the Veru Montanum is also very
apt to be produced by retaining the Urine too long,
when the bladder is very full, and particularly by
trying to prevent the escape of semen, during
coition, which is sometimes done by pressing the
Penis at its lower part. The effects of this practice,
which is often resorted to under the idea of prevent-
ing conception, are most serious ; in addition to the
inflammation already referred to, it also leads to in-
voluntary seminal losses, as will be explained
further on. Such destructive practices would never
be attempted if men were not so thoroughly igno-
rant of everything relating to their physical system,
and while that ignorance remains it will always
cause more disease than medical science will be
able to cure.

The Veru Montanum is also very apt to become
diseased whenever the Prostate Gland is affected,
the two parts sympathizing so intimately together.

The semen enters the Urethra just at the lower

DISEASES OF THE PENIS. 189

end of the Veru Montanum, by two small openings,
which are very liable to be more or less closed
when this organ, or the Prostate is inflamed, and
thus the flow of semen is partially and sometimes
totally prevented.

Sometimes the Montanum will swell till it com-
pletely fills up the neck of the bladder, so that
neither urine nor semen can possibly escape till it
has been reduced. It is also liable to be the seat of
Cancer or Scrofula, like the Prostate.

The Urethra is liable to Congenital Malformations
as well as to subsequent accidents, and some of
these may be of a serious character. In some
young persons it is permanently contracted, so that
the escape of urine is. attended with great difficulty
and pain. This fault, however, usually amends
with the growth, and with constant use. Children
so circumstanced are a very long time in discharg-
ing their urine, which flows in a small stream, and
with more or less distress. In very severe cases
bougies may be used to dilate the passage, but it is
better, if the trouble is not too great, to wait till
towards puberty, and see if nature herself will not
effect an improvement. Still more rarely there are
found Congenital Strictures, or they come spon-
taneously, without any apparent cause. If these
are not very bad it is perhaps better to wait till
fourteen or fifteen years of age, before operating, as
the changes in the system at that time are very
great, and an improvement may occur naturally.
If they are too severe, however, or endure beyond
that time, it will be necessary to use the bougie,
which is in reality the only effective, remedy in
such cases. Many youths cause stricture by com-
pressing the Penis in Masturbation, and bruising the

190 DISEASES OF THE PENIS.

Urethra. I have known many do this to prevent
the semen from escaping at the moment of ejacula-
tion, from the notion that if this was done the prac-
tice would not injure them. It is of course unneces-
sary to show the fallacy of such a notion, but it
may be advisable to explain what becomes of the
seminal fluid in such cases, because very often not
a particle is seen. At the moment of ejaculation
the semen escapes by jets into the Urethra, from the
ejaculatory canal, through certain small openings,
called the ejaculatory ducts — which are shown in
the plates — and then flows down the canal and
escapes from the body. If, however, the Urethra is
compressed, so as to prevent it from escaping exter-
nally, it must flow in some other direction, and the
only other way is into the Madder, which it enters
by forcing open the neck and passing on each side
of the Vera Mountanum. It is then expended as
much as if it had left the body in the natural man-
ner, as it comes away with the next flow of urine.
In the mean time its presence irritates the bladder,
and its passage in this reverse way is very apt to
cause inflammation in the Veru Montanum and
Prostate Gland, and even to produce stricture, as
before explained, with a weakness of the ducts dis-
posing to involuntary seminal losses.

The Urethra is also unusually irritable in some
persons, without any particular disease, and burns
and smarts when they urinate as if there were
Gonorrhoea. Some men, and even some children,
have more or less of this trouble, either constantly
or at times, and suffer from it considerably. It will
generally be observed in such persons that the
urine is high colored, and deposits a reddish or
yellowish sediment, on being allowed to stand,

DISEASES OF THE PENIS. 191

indicating either gravel or chronic inflammation
of the bladder. The best treatment is that given
for inflammation of the Veru Montanum, further
back, and the best preventive is to pay strict atten-
tion to the diet and drink. Nothing should be eaten
or drunk that is heating or stimulating, or that is
likely to produce constipation, which always aggra-
vates these troubles. Spirituous and fermented
liquors are very bad, and coffee is usually injurious.
The best drink is Soda-water, Barley-tea, Gum
Arabic-water, and Mucilage of Sassafras pith, or
Bene Plant. A little Carbonate of Soda taken
every morning is a perfect preventive in some, and
a little Magnesia in others. All excesses must be
carefully avoided, and the bowels kept constantly
free. A frequent warm-bath is nearly always bene-
ficial.

Many of the diseases of the Prostate Gland, and
many of the operations upon the Penis, are frequent
causes of stricture and inflammation of the Urethra,
and they therefore require, on that account, the
utmost care and attention. It is not unfrequently
the case, in unskilful hands, that after a perfect
cure of one of these diseases, a stricture is left that
is a worse evil than the original one.

THE PROSTATE GLAND.

The uses of this Organ, like those of the vesi-
cles, have not yet been satisfactorily determined. It
was formerly thought to be a simple Gland, intended
to secrete a peculiar Liquor which was necessary
to mix with the semen. This view, however, has
been lately somewhat modified, and it is now
considered to be rather a collection of several glands

192 DISEASES OF THE PENIS.

or follicles, forming one mass or organ together.
These little follicles secrete a peculiar whitish fluid,
which is conveyed by a number of small ducts into
the Urethra, close by the Veru Montanum where
the semen enters. It is probable that this fluid is,
in some way or other, essential to the perfection of
the semen as it leaves the body.

The Prostate Gland is liable to several forms of
disease, some of which are both painful and dan-
gerous, and all of which, unfortunately, are but
little capable of treatment. It seems specially liable
to engorgment, or swelling, and to scrofulous and
cancerous indurations. Sometimes also it becomes
cartilaginous, or even almost bony, and at other
times calculi or stones form in it, similar to those
found in the bladder. — Inflammation and abscess -of
the Prostate Gland is very apt to follow improper
treatment for Gonorrhoea, particularly where bou-
gies or injections have been used, and it is also a
frequent consequence of cauterization for curing
involuntary seminal losses. Blows on the Peri-
neum may also give rise to it, or too severe and
long-continued pressure, from horse-riding, or using
a hard seat, or even from very tight small clothes.
This trouble is both an annoying and a serious one,
and frequently excessively painful. When the
Prostate is simply swollen it merely causes a sense
of fulness and uneasiness in the Perineum, with
difficulty in urinating or discharging the semen,
and in passing the bowels. The reason for these
impediments will be evident when the situation and
connections of the Organ are borne in mind. The
smallest increase in the size of the Prostate makes
it press on the Urethra and partly closes it, so that
the flow of urine is necessarily obstructed, and the

DISEASES OF THE PENIS. 193

orifices of the Seminal Tubes being also compressed,
the flow of semen through them is similarly inter-
cepted. In very severe cases a total stoppage of
both urine and semen occurs, which if not relieved
may lead to inflammation of the Bladder and Tes-
tes of the most acute and dangerous character.
When this stage has been reached the pain and suf-
fering become most intense, and if the inflammation
and swelling is not speedily reduced an Abscess
forms which eventually breaks and discharges its
contents, when some little relief is obtained, though
the disease has then assumed a much more annoy-
ing form, and is more difficult to treat. If the
abscess breaks internally there is a continual flow
of pus or matter from the Urethra, attended by se-
vere smarting and pain when the urine or semen is
passed, and by a constant irritation in all the neigh-
boring parts, which acts on the nervous system in
the most distressing manner. Occasionally the ab-
scess breaks externally in the Perineum, which is,
if possible, still more troublesome. The pus keeps
flowing in the same manner, only not. from the Ure-
thra, and the same constitutional irritation is expe-
rienced, but the pain in urinating is not always so
great.

The treatment of this trouble must depend upon
the stage at which it has arrived, and the causes
that produced it. While there is simply slight
swelling and inflammation from bruises or blows,
every means must be taken to remove it as speedily
as possible. The patient must keep perfectly still,
lying on his back most of the time, while fomenta-
tions of hot water, with laudanum, are freely applied
to. the Perineum, or flannels dipped in the hot fluid
may be placed between the limbs and pressed up

17

194 DISEASES OF THE PENIS.

against the Perineum, changing them frequently, and
using them as hot as they can be borne. The bowels
must be freely moved with Castor Oil and the diet
must be light and unstimulating. A very good
practice is for the patient to sit in hot water, for half
an hour at a time, or over the steam of it. — These
means persevered in, when the uneasiness and diffi-
culty is first felt, will often subdue the inflammation
and prevent any further evil consequences. A ge-
neral warm bath, during which hot Teas are taken,
to promote perspiration and the flow of urine, are
also of great service, and when the bruise is very
bad, as shown by blackness of the skin, Leeches
must be applied, either on the Perineum or inside
of the thighs.

If the inflammation be of a chronic form, not
produced by any external violence, the best appli-
cation is the Mercurial Ointment rubbed on the Peri-
neum till it produces a decided effect on the system.
Along with this may also be taken the solution of
Iodide of Potassium, prescribed in Hydrocele, the
bowels being kept regularly open with Salts or
Castor Oil. Cold Lotions must be frequently ap-
plied of Alum or Sugar of Lead, and no spices or
alcoholic liquors must be taken on any account.
Sexual excesses are particularly hurtful in this
complaint.

Very many incipient attacks of inflammation of
the Prostate might be cured in this way, and the
swelling dispersed, if proper attention were paid to
the diet and strict temperance practised in all
things.

Most frequently, however, this trouble continues,
and either forms an abscess or an indolent Tumor,
which every now and then enlarges so much that

DISEASES OF THE PENIS. 195

the flow of semen and urine is entirely stopped,
causing intense suffering, and a palliative operation
has to be performed to give relief. Many patients
suffer from regular periodical attacks of this kind,
and in others they come on always after any little
extra bodily exertion or mental anxiety. In these
cases the use of purgatives internally, with cold
lotions and Belladonna or Hellebore Plasters exter-
nally, will frequently mitigate the severity of the
pain and cut short the attack. A grain of Opium
may also be taken, when the suffering is most in-
tense, or thirty drops of Laudanum, in some Gum
Arabic-water. The Ointment of Belladonna and
Camphor, prescribed in inflammation of the Tes-
ticle, will also frequently be found of great benefit,
and many experience decided relief from leeches to
the Perineum and thighs. The nature of the
operation to be performed, in any extreme case, de-
pends upon the peculiar circumstances attending it,
and must be left to the judgment of the physician.
The internal application of caustic is practised by
some, and others use the lancet freely, but there is
both risk and difficulty in both. At the very com-
mencement of the difficulty it is sometimes possible
to introduce a catheter without much trouble, and
this may serve to keep the Urethra open while the
other means are employed to reduce the inflamma-
tion. The catheter, however, is not admissable
when much force is needed to introduce it, nor
when it increases the inflammation. One of the
most reliable proofs of swelling of the Prostate
Gland, when the Tumor cannot be felt externally or
in the rectum, is the impossibilty of passing a
catheter, owing to the enlarged Prostate having
blocked up the Urethra.

196 DISEASES OF THE PENIS.

Inflammation of the Prostate Gland may termi-
nate in induration or permanent hardness, and also
in mortification, as well as in abscess or dispersion.
When mortification ensues it is of course exceed-
ingly dangerous, if not necessarily fatal, and we
have no known remedy to cure it. The induration
will sometimes exhibit a decided Scrofulous ten-
dency, and pursue the same course as Scrofulous
Testicle, and at other times it will become perfectly
cartilaginous or bony.

When calculi or stones form in the Prostate it is
sometimes possible to cut them out, when their pre-
sence is so evident that there can be no mistake, but
this is very seldom the case. Like most other dis-
eases of the Prostate the indications of this are so
obscure that its precise seat and nature in most
cases can only be obscurely guessed at.

Sometimes the stones will be discharged, by way
of the Urethra, and relief immediately follow.
Warm bathing and fomentations probably tend to
facilitate this mode of escape, by releasing the
parts. I have known persons who had long suffered
from all the usual symptoms of enlarged Prostate be
perfectly relieved after voiding a few calculi, sel-
dom larger than a pea.

Among other means of obtaining relief occa-
sionally successful, in Prostatic enlargement, I may
mention injections in the Rectum of cold thin starch
and laudanum, frequently repeated. Galvanism I
have also tried, and in some cases with marked
success.

Chronic enlargement of the Prostate Gland is
rather common amongst old men, particularly those
who have led a sedentary life or been addicted to
sexual excesses.

197

CHAPTER VI.

FUNCTIONAL AND SYMPATHETIC DISEASES OF
THE GENITAL ORGANS.

This is a part of our subject of the very first im-
portance, and yet beset with such numerous and
peculiar difficulties that precise knowledge about it
is extremely difficult to obtain. In regard to many
things of the greatest moment, connected with
man's virile powers, but little or nothing is known,
even by medical men, who are, generally speaking,
taught nothing about them in their earlv studies, and
have but few opportunities of learning afterwards.
Dr. Curling remarks, when speaking of the Testes,
" Their functions are so involved in those of other
parts, are influenced by such peculiar causes, and
are so dependent on and modified by particular
events and circumstances, that the investigation of
them, when disordered, necessarily becomes of a
complex and difficult character. The product too,
of these glands, is one, the qualities of which it is
almost impossible to appreciate, and which during
life is never afforded in a pure and unmixed state ;
and further, taking into account the repugnance felt
to such inquiries, it is scarcely surprising that the
subject has been but imperfectly investigated, and
rarely treated of by the pathologist and practitioner.
Indeed the little information we possess respecting
it is chiefly to be found under the head Impotency,
in works on medical jurisprudence, in which it is
cursorily considered, principally in relation to points

17*

198 SYMPATHETIC DISEASES.

of medico-legal interest, and scarcely at all in re-
ference to practice."

This is strictly true, and it will, I dare say, sur-
prise many persons to learn that physicians, gene-
rally speaking, know little or nothing about such
matters. Such, however,, is the case, as is well
known to those who have occasion to apply to them,
either for advice or information. I have found it
absolutely necessary to set out in my investigations,
on many important points, as if nothing were
known, and hunt out the requisite information by
the tedious but sure process of actual experiment
and extended observation. Very many of the
statements made in this work will probably surprise
those who see them for the first time, owing to their
novelty, and to their variance with old notions.
None of these statements have been made, however,
without good and sufficient evidence having been
obtained of their correctness, while the old notions
with which they conflict are merely suppositions
and assumptions utterly destitute of any foundation
whatever. This is especially the case in' regard to
the functional and sympathetic causes of Impotence,
and also its medical and moral treatment, which
may be truly said to be, nearly invariably, of the
most quackish character, even when practised by the
most eminent medical men. The notions of non-
professional persons, respecting such things, are
frequently as correct as those of their medical advi-
sers, and their own empirical treatment is often the
most successful. It is but very recently that the
true action of many powerful medical agents on the
Generative Organs has been ascertained, and I as-
sert, without hesitation, that very many practitioners,
some even of considerable celebrity, are as truly

SYMPATHETIC DISEASES. 199

ignorant in regard to it as the patients tney under-
take to treat.

In pursuing my own investigations into these im-
portant and interesting subjects, I have left no
means of acquiring information untouched. Besides
studying and experimenting, as far as was proper,
in thousands of cases that came under my notice
professionally, I have fully experimented upon
hundreds of animals, to the utmost extent that
humanity would allow. By these means I have
ascertained many important facts, and studied the
action of many powerful medical agents which
could not with propriety and safety have been tried
upon human beings first.

Functional or sympathetic disability of the Re-
productive Organs appears in two forms, Impotence
and Sterility, which are frequently, but erroneously,
confounded together. Sterility means a total
absence of the Reproductive principle, and must
always be accompanied by impotence or inability
to associate with the other sex, except temporarily
in certain peculiar cases ; but a man may be
impotent without being sterile. Absolute sterility
is generally incurable, because it arises from de-
struction or disorganization of the Testes, and it is
therefore only in the way of preventing the evil, by
removing its causes, that we can do any good, but
impotence can very frequently be cured, as well as
prevented. Besides impotence is the more frequent
affection, and is often merely the forerunner or first
stage of sterility, and it becomes therefore the most
important subject to consider.

The various kinds of deformity, deficiency, and
acute disease that cause destruction of the genera-
tive power have already been fully treated upon,

200 SYMPATHETIC DISEASES.

md we have now only to explain those mysteri-
ous sympathetic and functional agencies, which,
though they are often more powerful, are yet so dif-
ferent in their operation, and hitherto so little
studied, that but little is generally known respect-
ing either their nature or mode of action. This
will be fully apparent in our very next article.

INFLUENCE OF THE BRAIN ON THE GENERATIVE
POWERS.

In a former part of this work a number of in-
stances were narrated in which impotency followed
injuries of the head, and we will now narrate a few
others, because this is a most important fact, in
many respects.

About five years ago [ was consulted by a mar-
ried man who had totally lost his sexual powers
from striking his head against a beam. The blow
had stunned him for a time, but did not lead to any
serious symptoms afterwards. He found, however,
in two or three days after that he was perfectly im-
potent, and had so remained for eighteen months
when I saw him. There was but little loss of de-
sire, with no wasting of the Genital Organs, nor
any other indication whatever of his deprivation.
He had previously been a man of temperate habits,
and at the time of the accident was as vigorous as
most men. The blow, it may be as well to remark,
was received on the top of the head, and was not fol-
lowed by any swelling or pain in the Cerebellum or
neck. When I saw him he was in perfect health,
and in good spirits, in fact nothing was complained
of but this unfortunate impotency, which he was
very desirous of having removed.

SYMPATHETIC DISEASES. 201

The great point was to ascertain, if possible, in
what way the concussion of the brain had suspended
the transmission of nervous power to the genitals,
and how it could be restored. I recollected that in
several cases where injuries to the head had para-
lyzed particular muscles, or limbs, their power had
been restored by Galvanism, applied so as to pass
along the course of their Nerves from the spine.
It seemed to me as if the blow had impaired the
proper connexion between the spinal marrow and
these nerves, at their roots, and that the passage of
the electric current in some way or other restored
that connection. It was similar in fact to starting
the Electric Telegraph again by mending the wires,
or making the connections perfect, after they had
been destroyed by violence. I therefore applied
the Galvanism, passing the current from that part
of the spine where the Spermatic Nerves originate
to the pubes, perineum, and neighboring parts, ap-
plying also a stimulating liniment, and occasionally
using the congester. The result was highly satis-
factory, and speedily obtained. At the third appli-
cation he experienced a decided tingling about the
perineum, and along the penis, and the next time a
partial erection occurred. After persevering for
five weeks, using the Galvanism daily at first, and
then every other day, and finally but twice a week,
he was fully restored, without any apparent tendency
to a relapse. In this case it will be observed that
the injury was not received at the hack of the head,
on what the Phrenologists call the Organ of Ama-
tiveness, but at the top, nor did it in any way what-
ever affect the cerebellum.

In another similar instance Impotency, with com-
plete loss of desire also, followed a fracture of the

202 SYMPATHETIC DISEASES.

skull over the left Temple and no means that were
used had the slightest effect in restoring it. In a
few months the Testes began to waste, and even-
tually almost totally disappeared, but the general
health was only slightly affected.

In the American Journal of the Medical Sciences,
for February, 1839, Dr. Fisher relates a curious
instance of a gentleman injured in a railway car.
He was looking out at the moment when a colli-
sion occurred, and the shock threw the back of his
head against the edge of the window with such
force as to stun him ; he however recovered his
senses and was taken home, but suffered great pain
in the back part of the head and top of the neck.
His right arm was numbed a little and some diffi-
culty was experienced in passing the urine, but in
two weeks he was able to walk out with no other
inconvenience than a slight dimness of sight. About
the fifth week he discovered that he was impotent,
and had lost all sexual desire. The means used to
restore his genital powers were only partially suc-
cessful, nor was his memory so perfect as before,
but all the other difficulties disappeared under pro-
per treatment.

In the Lancet for August, 1841, is an account of
a medical student who received a blow on the face,
in a quarrel, which knocked him down so that he
fell on the back of his head. He was totally un-
conscious for eight or ten hours, but gradually re-
covered, and on the following day even resumed his
studies which he continued unremittingly for the
next six weeks. He, however, became exceedingly
irritable, with a feeling of general uneasiness, and
after the first week he observed the genital organs
begin to waste, and desire to weaken, till he finally

SYMPATHETIC DISEASES. 203

became nearly impotent, but afterwards recovered
under proper treatment.

Many instances have been observed of soldiers
beino- wounded in the head and sufferinc- afterwards
under the same disability, some of which were given
in a former article. It is perhaps proper to remark,
however, that this is not the only nor even the most
frequent result of such injuries, as many patients
so hurt suffer no deprivation of their genital powers
but have some other function impaired. Thus some
lose their sight, some their hearing, and others be-
come paralytic in their limbs.

The prospect of recovering the sexual powers
when lost from injuries of this kind is very small,
especially if the parts have really begun to waste.
The treatment at first must be that best calculated
to subdue the irritation which is probably exist-
ing in some part of the nervous system, and after-
wards, if requisite, to rouse the spermatic nerves to
more energetic action. Every case, however, will
require something peculiar to itself, which can only
be discovered by a patient and careful attention to
all its symptoms and indications.

A further corroboration of the facts above stated
may also be found in certain physiological indica-
tions observed in those who have died from strangu-
lation. It is well known that in very many men
who have been hung, erections and even seminal
emissions have occurred, and experiments upon
animals have often led to the same result. This is
attributed to the pressure of the rope on the back
of the head, which in some way or other excites
the spermatic nerves. I have even known pressure
made on that region purposely, in a particular man-
ner, in order to excite erections, and frequently with

204 SYMPATHETIC DISEASES.

'perfect success. Some of the females in the Turk-
ish Harems understand this, and they habitually
chafe, or sha?npoo, the back of the neck of their
companions of the other sex, for this very purpose.
I have frequently made an application of this .im-
portant fact in my practice, in cases where there
was merely a suspension of that sympathetic influ-
ence which the brain ordinarily exerts upon the
sexual organs.

The particular mode of doing this, though well
understood to eminent medical men in the old world,
is I believe totally unknown here. An explanation
of the process, and the apparatus employed, would
require to be extended beyond the limits of the pre-
sent work, to make it practically understood, and as
after all it would not be available for the patient's
own use it is not necessary to enter into it. I have
often astonished persons both by its singularity and
its unexpected effects.

A full consideration of all the facts and argu-
ments bearing upon this influence of the brain over
the sexual functions, have left the subject, so far as
I am concerned, in great obscurity. That a singu-
lar influence is often exerted by the brain in this
way, sometimes benefically, and at others the re-
verse, is undoubted, but whether such influence
emanates from a particular part of the brain, or
from the whole organ is uncertain. The Phrenolo-
gists affirm that only a particular part of the
Encephalon is concerned in this phenomenon, name-
ly, the lower part or Cerebellum, which rests upon
the spinal marrow.

But after a careful consideration of all the reasons
brought forward in support of this affirmation I am
not yet convinced of its correctness. That many

SYMPATHETIC DISEASES. 205

facts favor such a theory I am willing to admit, but
it is also certain that many others militate against
it, and as a searcher after truth I must consider
everything that bears upon the question, even though
opposed to my previous opinion. I set out with
firmly believing that the Cerebellum was the organ
of the sexual propensiy, and my investigations have
made me doubt it. It is not true, I am convinced,
that the strength of a man's sexual propensity can
be estimated by the development of his Cerebellum,
nor is it true in regard to animals either. If it
were so we ought to find that organ largest in those
who exhibit the propensity most, and in numerous
cases it is not so, though in others it is. A celebra-
ted German physiologist made some investigations
bearing on this point of a very interesting charac-
ter ; he had numerous opportunities of dissecting
horses, and curiosity induced him to weigh the
Cerebellums of these animals, some of whom had
been castrated when young and others left entire.
Now if the Cerebellum be truly the organ of
Amativeness it ought of course to be largest in the
entire horses, who have always exhibited that pro-
pensity, and we should expect to find it almost dis-
appeared in the others, seeing that they could never
have felt anything of the kind. The result of the
experiment was, however, on taking the average of
an equal number of each, that there was scarcely
any difference, or if any at all the castrated ones
had the largest Cerebellums. In observing idiots
also, some of whom were notoriously licentious,
and others directly the reverse, I have not found
that the development of the Cerebellum corres-
ponded to the phrenological system. Neither can it
be contended that the size of the Cerebellum in the

'8

206 SYMPATHETIC DISEASES.

castrated animals was only the result of disease, for
no difference could be detected in it between them
and the others. All that can be said therefore is
that certain agencies acting on the Cerebellum
sometimes cause sexual manifestations, and at other
check them. The same agencies also acting on
other parts of the brain will sometimes produce the
same results, and sometimes when the Cerebellum
is acted upon it is not the Generative Organs that
are affected, but the sight, hearing, or speech, which
might therefore just as properly be considered under
its exclusive influence.

It should also be stated, as bearing on this sub-
ject, that certain influences operating on various
parts of the body will often affect the Generative Or-
gans in a decided manner. I have known a blister on
the leg cause the most uncontrollable sexual desires
in one man, and the application of caustic to the
throat do the same in another. In applying blisters
to the top of the neck also, though it is followed by
erections in some, yet in others no such effect takes
place, and occasionally it will produce a nervous
twitching, like St. Vitus' Dance, in the arms.
Flogging the back, it is well known, will frequently
cause erections and emissions, even when very
severe, as has often been observed in soldiers when
undergoing that brutal punishment. Rousseau also
tells us, in his confessions, that flogging boys at
school, in the disgraceful manner formerly prac-
tised, is sometimes followed by similar results, and
he remarks that the pain of the punishment may be
forgotten under the powerful excitement it leads to,
a fact of deep moral importance. In short there
seems every reason to believe that the strength of
the sexual propensity is dependent upon some pecu-

SYMPATHETIC DISEASES. 207

larity of the sexual organs themselves, though it
may be often modified by various mysterious sym-
pathies emanating from other parts. If the semen
be never formed, there will never be any sexual de-
sire, and if that fluid be abundant the propensity to
discharge it will be proportionally great, indepen-
dent of all other influences. In those who feel de-
sire without having any semen, as is sometimes the
case in impotency, or even after castration, it is
only the remembrance of a lost 'pleasure.

In treatino; disabilities of the Generative Organs,
however, the possible influence of injuries to the
head, even at former periods, and long ago, should
always be borne in mind.

INFLUENCE OF THE MIND OVER THE GENERATIVE
ORGANS.

It is a fact not generally known that the mind
can exert an influence over the Generative Organs
of a most decided character. Not only can desire
be engendered or annihilated by mental impressions,
in despite of all other conditions, but the actual
growth, or development of the organs themselves
can be retarded or accelerated by the same means.
I have known men who never felt sexual desire,
and whose organs were very imperfectly developed,
until a late period of life, and then quite suddenly
the long-suppressed feelings were experienced, and
the parts began to grow, simply from the stimulus
of seeing some person of the opposite sex who was
adapted to make the proper impression upon their
minds. Such instances are, indeed, by no means
rare, as every person of experience must know, and
they prove that, in many cases at least, a certain

208 SYMPATHETIC DISEASES

impression must be made upon the mind before the
mere animal feeling can be experienced, or the
physical development take place ; or, in other
words, they prove that with some persons there are
only certain individuals of the opposite sex who can
call forth those feelings in them, and that if they
never meet with these individuals it is probable that
such feelings will never be experienced, or at least
only to a slight extent.

A knowledge of this fact will often explain to us
many of those distressing cases of indifference and
dislike to be met with between parties, and will also
be a valuable guide in giving advice, particularly
in those instances where there is only apparent impo-
tence without any real deficiency.

There seems to be good reason to suppose that
the sexual instinct is materially dependent upon a
particular part of the brain, though we cannot tell
what part it is, nor whether it is a mere develop-
ment of it that is needed or some peculiarity of
structure or organization. It is not at all uncom-
mon to find men perfectly organized, in every re-
spect, with vigorous minds, and with every other
faculty in full play, but yet almost wholly destitute
of desire for sexual enjoyment. In some of these
cases it is true the Generative Organs are small, or
evidently inactive, but in others they are of full
average development, healthy, and active. In such
cases we can only account for the singular indiffe-
rence exhibited by supposing that the part of the
Brain which regulates the reproductive instinct has
not had sufficient power, or else that the proper
object has not yet been presented to the senses, as
before explained.

Besides this particular influence the Generative

SYMPATHETIC DISEASES. 209

Organs can also be much affected by the general
action of the Brain and nervous system, the same
as all the other organs. Thus if a man exhaust
most of his nervous energy in thinking or in mus-
cular energy, the other functions, including the ge-
nerative, must be proportionally weakened. I have
met with many instances of this among men of bu-
siness, many of whom would become quite, impotent
when more than usually absorbed in their pursuits,
and regain their powers in a short time after their
care and anxiety were lessened. The following case
of this kind I select from my note-book as being
more than usually instructive. The patient, a
young man of twenty-eight, had been married three
years, and had one child ; he was very fond of his
wife, and she in return reciprocated his affection.
He had never been addicted to excesses or abuses
of any kind, and until about six months before I saw
him was in the full enjoyment of his generative
powers. About that time, however, he experienced
a sudden and severe loss in his business, which had
previously been very prosperous, and the care, anx-
iety and incessant exertion he underwent, in endea-
voring to extricate himself from his embarrassments,
brought on various physical and mental troubles
that he had never before experienced. Among the
rest he found himself perfectly impotent, having
completely lost both power and will. This dis-
tressed him very much, both for the loss itself and
also from apprehension that it was the beginning of
general decay. In this dilemma he came to consult
me, and was exceedingly anxious to know my opi-
nion as to the prospect of his ultimate recovery.
After a careful examination I felt convinced that
there was no actual loss of power, but merely a

18*

210 SYMPATHETIC DISEASES.

temporary absence of the requisite nervous stimu-
lus, owing to the excessive mental labor and anxiety
he had undergone ; I therefore inquired as to his
future prospects, and was gratified to learn that he
was now quite relieved of his difficulties and was
beginning to regain his usual health and spirits.
On learning this I unhesitatingly assured him that
in a short time his generative powers would return,
and more especially if he could abandon all care
and thought about them. I gave him a slight sti-
mulus, and some general directions as to diet, exter-
nal treatment and exercise, and arranged to see
him twice a v/eek. In one month afterwards he was
as well as ever, though he had been for nearly seven
months as impotent as if the organs had been totally
destroyed. — I have also frequently had business-
men remark to me that they were liable to expe-
rience more or less deprivation of sexual power,
and to feel much less desire, at those periods of the
year when trade was most active, and their minds
in consequence more absorbed. An author also
told me that when writing any very particular part
of a book, or when anxiously expecting the criti-
cisms of the press after its issue, he was always for
a time perfectly impotent. In the lives of several
severe students we have further corroboration of
this fact, many of them having been remarkable for
their coldness and incapacity, particularly those en-
gaged in absorbing abstract studies, like the Mathe-
matics. Sir Isaac Newton is said to have never
known sexual ardor, though in every respect a per-
fectly-formed man, and it is probable that this was
in a great measure, if not entirely, owing to his in-
cessant and all-absorbing studies. In short there is
no question but that intense mental occupation less-

SYMPATHETIC DISEASES. 211

ens sexuai ardor in most persons, and that it may
sometimes even extinguish it altogether. This is a
fact of considerable importance, both medical and
moral, and one that should be more fully considered
than it has hitherto been. There is no doubt but
that a great part of the licentiousness which exists,
particularly in youth, is in a great measure brought
about, or at least made much worse, by mental and
bodily idleness. If the mind is not occupied by
some proper and congenial study, that will pleas-
ingly engage it at every leisure moment, a habit
will soon be formed of indulging lascivious thoughts
during such vacant periods, and if at the same time
a due proportion of the vital energy is not absorbed
in physical exertion, the sexual organs will soon
become so constantly and intensely excited that such
thoughts will become paramount over all others. I
once pointed out the philosophy of this to a gentle-
man who came to consult me both for himself and
for his son, aged seventeen. The father was nearly
impotent from intense occupation in business, and
the son was nearly dead from constant licentious-
ness and intemperance. I found on inquiry that
the young man had been brought up as a gentleman,
and was not even expected to employ himself with
anything useful, in consequence of which, from
mere idleness, he resorted to licentiousness and
drinking as a regular occupation, till he was
scarcely capable of anything else. Moral suasion
was utterly useless to effect a change, and habit
was too strong for the fear of consequences to break
through, so that it seemed as if nothing could be
done but abandon him to his fate. His father bit-
terly deplored the condition of his son, and earnestly
entreated me to give him any information I thought

212 SYMPATHETIC DISEASES.

likely to be of service in preventing similar misfor-
tunes to his younger brother.

On explaining to him how the sexual power and
propensity is influenced by a proper exercise of the
rest of the system, the philosophy of his own and
his son's condition was immediately apparent.
" Yes," exclaimed he, " I have exhausted myself
by over-exertion, and at the same time, I have left
my son a prey to his licentious desires merely from
idleness. I now see plainly enough that had part
of my burden been laid on his shoulders it might
have saved both, but from mistaken kindness, and
false pride, I condemned him to a life of inactivity,
and consequent depravity, and myself to a drudgery
that has left me a mere ruin of what I was." Now
this is a case instructive to all, and there are many
others in society precisely similar.

Certain feelings are also very influential over the
generative functions, but only temporarily, or with
particular persons. Thus some men have found
themselves suddenly impotent, with certain females,
merely from disgust at something that was un-
expectedly displeasing in them, and others have
experienced the same difficulty from the fear of
discovery or infection. Some men will experience
a total loss of power on finding their companions too
cold, or too ardent, or meeting with some unusual
difficulty, but perhaps the most frequent cause is
Timidity, or self-distrust. I have known several
men, every way competent, who were so possessed
with this idea of their own incapacity that they in-
variably became impotent whenever they attempted
an approach to the other sex. This timidity is
sometimes exhibited in the most striking manner,
the patient being intensely agitated, and so nervous

SYMPATHETIC DISEASES. 213

that his whole frame trembles, and his bodily-
powers sink so much that often fainting ensues.
This peculiarity appears to be constitutional, and is
often seen in those who are by no means nervous, in
the ordinary acceptation of the term, and who are
collected enough in regard to other matters. The
onl}'' remedy for such an infirmity is constant asso-
ciation with one object, in marriage, by which means
a proper familiarity is induced, and in time the in-
dividual loses his distrust and becomes convinced
of his perfect capability. In most of these cases
there is a real excess of power, rather than a defi-
ciency, and the very intensity of the feeling tends
to prevent its gratification, by completely absorbing
all the vital energies. I have frequently been con-
sulted by persons so circumstanced as to the pro*
priety of marriage, they fearing that the failing
could not be recovered from, and it has been with
the greatest difficulty that I could persuade them to
the contrary. In every instance, however, I have
found marriage to effect a cure, though it might not
be immediate. Some have worn off their distrust
very soon, others have experienced it for months,
"but eventually have been surprised that they ever
did so at all. It is the fear of failure that causes it
with these people, and when that fear is once found
to be groundless the cure is complete. In some few
of these cases a little medical assistance is availa-
ble, but it is of a nature not necessary to point out
here. I once saw a man who had been married for
three years without being able to associate with his
partner, and solely from this cause. In all proba-
bility he never would have done so, had it not been
for the advice he received, and yet there was no
real deficiency of any kind. The celebrated John

214 SYMPATHETIC DISEASES.

Hunter gives us a similar instance, which he met
with in his practice. The patient was perfectly in-
competent, solely from the fear of failure, which so
operated upon him as to always make him fail..
Mr. Hunter was persuaded there was no other dif-
ficulty, and that it was merely necessary to break
this spell, he therefore required of him, as one es-
sential requisite of the treatment, that he should
remain with his companion, but on no account
whatever make any attempt for six nights, let his
desire be ever so strong. The result was that be-
fore the period fixed had gone by his desires were
so strong he found it difficult to obey the injunction,
and feared he should have too much power instead
of too little. In fact the cure was complete, with-
out any further treatment. The only thing re-
quired in such cases is a judicious and honest phy-
sician, who will first ascertain that there is no real
deficiency, and then explain to the patient the real
nature of his case and the means by which it may
be relieved. If this be done in a proper and sym-
pathizing manner a cure may always be effected,
but by a wrong course of procedure the evil may
be confirmed.

A too great intensity of the sexual feeling itself
will sometimes cause impotency, by overpowering
the patient before the act can be properly consumma-
ted. I have known instances of men who always be-
came so intensely excited that they fell into a kind
of dreamy stupor, and had involuntary emissions
while in that state. This, however, can alway be
remedied by proper treatment.

Several instances have come to my knowledge of
men being impotent, at their marriage, from their
first discovering some disagreeable fact respecting

SYMPATHETIC DISEASES. 215

their partners. In one instance the lady had a
small abscess on the arm, which she had hitherto
concealed, and doubtless thought it a matter of little
or no consequence as her health was good, and her
appearance remarkable pleasing. Her partner,
however, thought different, and such was the effect
upon his mind that he could never afterwards expe-
rience the slightest desire towards her. In some
cases such simple discoveries as false hair, or false
teeth, have had a similar effect. It is not so much
that the circumstance is excessively disagreeable in
itself as that it is unexpected, and its discovery de-
stroys the dream of comparative perfection hitherto
indulged. With uncultivated and unimaginative peo-
ple such causes might operate but slightly, or not at
all, because they form no such ideal image, but
with men of refinement it is different. There is no
doubt but that a good deal of the dissatisfaction,
and loss of power, which many men experience
after marriage is owing to this circumstance. Thev
are ignorant of the real physical and moral nature
of the being they take to their bosoms, and have
formed a picture of her in the imagination very
different from the reality, so that when the truth is
known their feelings undergo a complete revulsion.
This ignorance sometimes extends to the most
ordinary functional phenomena of the female sys-
tem, and the first knowledge even of that has, to my
own knowledge, produced a very disagreeable and
lasting effect. In short it is in this as in everything
else, ignorance and concealment produce evils that
only knowledge and mutual confidence can prevent
or remove.

216 SYMPATHETIC DISEASES.

EXCESSIVE SENSIBILITY OF THE GENITAL ORGANS.

Sometimes the sensibility of the Genitals is so
much exalted, either naturally or accidentally, that
emission occurs upon the slightest excitement, and
the individual is thus made impotent from inability
to perfect the connexion. This condition is in rea-
lity a diseased one, and ought so to be considered,
as much as any other we have described.

The seat of this extra sensibility is sometimes in
the Testes or Vas Deferens, or in the ejaculatory
Ducts, but most frequently in the Glans Penis.
When it is very great the organs are thrown into a
violent orgasm almost at a touch, and emission oc-
curs at the very first attempt. I have known men
married for years who never had perfect association
with their partners during the whole time, and
simply from this cause. They were in no respect
whatever deficient, nor even subject to nervous ex-
citement, but were unfortunately affected by this
excessive sensibility. Other men I have known
who dare not marry at all from this cause, feeling
sure that if they did the marriage could never be
consummated.

The causes of this trouble appear to lie in the
peculiar structure of the Glans, the skin of which
is unusually delicate, while its nerves are ramified
into thousands of minute twigs, which are distributed
to every point of the surface. The exquisite sensi-
bility thus produced is so great in some that the
mere touch of the clothes is sufficient to excite, and
the patient is thus kept in a constant state of irrita-
tion. Sometimes a similar state is induced by dis-
ease, particularly by inflammation, the Penis being

SYMPATHETIC DISEASES. 217

then as tender as the surface of an abscess just be-
fore it breaks, and feeling the slightest pressure or
friction.

When this excessive sensibility is produced by
any disease it will of course disappear when the
disease is cured, but when it is natural the removal
or modification of it becomes much more difficult,
though great relief can nearly always be obtained.
The first requisite ts to remove all extraneous
sources of irritation, and to attend to the diet, cloth-
ing, and general regimen, then the great point is
to harden the skin of the Glans, so that the nerves
may be more thickly covered, and their sensibility
reduced. This must be effected by the constant
use of astringent washes, or caustics, and in certain
cases by the use of Galvanism. Every one is fa-
miliar with the effect of certain substances on the
hands for instance, in making them hard and de-
stroying the delicacy of their touch, and it will be
readily seen that the same means will deaden the
sensibility of other parts. Lime-water is very goodi
in some cases, and water saturated with iron-rust in
others, but the best agents are the astringents, such
as alum-water, solutions of tannin or white oak
bark, or gum kino or catechu. These must be
used every day, as washes, and the Glans kept,
covered with cotton soaked in them. They will
always do good, and frequently effect a perfect
cure, but when they are not sufficient caustics
must be employed, and this must be done by a phy-
sician.— When the premature discharge takes- place
from irritability of the Urethra or ejaculatory ducts,
a soothing external treatment must be adopted, con-
sisting of washes and baths, combined with the use
of particular medicines internally, the kind o£

19

218 SYMPATHETIC DISEASES.

which must be determined by the peculiarity and
seat of the irritability. — I have had some of the
most distressing cases of this extreme sensibility
brought under my notice, but I have not had one
that was not relieved, except when it arose from
some incurable disease. — The connexion between
this complaint and certain moral infirmities will be
obvious, and it will be readily admitted that its pro-
per treatment may frequently be a matter of great
consequence. — Children sometimes exhibit this trou-
blesome sensibility of the parts, and it leads in them
to constant manipulation, and eventually masturba-
tion, if not corrected. How important that parents
should know this, and how necessary that they
should see the uselessness of mere moral preaching
in such cases. ;

219

CHAPTER VII.

SPERMATORRHOEA, OR EXCESSIVE LOSS OF
SEMEN.

This is a subject of more importance, as regards
human health and happiness, than perhaps any other
that can be mentioned, and yet it is one about which
scarcely anything is known, except by a few indi-
viduals. I do not hesitate to say that more evil
effects, ten times over, are produced by this almost
unsuspected cause, than by all the diseases already
enumerated, and perhaps even then by nearly all
other diseases put together. And not only is it de-
structive to the body, by preventing its proper deve-
lopment in youth, making it a mass of disease in
mature life, and causing its premature decay and
death, but it is equally baneful to the mind. By
its influence the vivacity and energy of youth is
changed to a listless indifference, the vigor of man-
hood is destroyed, and the calm peaceful content of
mature life is turned into despondency and gloom.
Many a young man, with mental powers capable of
making him both eminent and happy, and with
every requisite of bodily health and strength, has
terminated a short-lived miserable existence by sui-
cide, or dragged out his life in a state of idiotic
imbecility through this unsuspected disease.

The excessive loss may either be the result of
licentious indulgence or it may occur without the
individual's cognizance, the effects being much
the same in either case, though apt to be ascribed

220 EXCESSIVE SEMINAL LOSSES.

to other causes in the latter case, and also to be
often underrated.

The fact that the semen does frequently escape
in an involuntary manner is generally known, there
being but few men who have not so suffered more
or less, and it is also well known that such involun-
tary losses are very injurious to health, but the real
extent either of the disease or its evil effects are
known to but few. The only cases known to occur,
by people generally, are those in which the escaped
semen is actually seen, but for one case of this kind
there are probably ten where nothing of the kind
can be observed except by means hereafter to be
pointed out, and where of course it is never sus-
pected. In like manner the only effects of this dis-
ease that are usually taken cognizance of are those
of plain and obvious character, but there are many
others, much more to be dreaded, that can only be
detected, and assigned to the right cause, by those
practised in observing them. Many men surfer the
extreme of wretchedness and disease, become in-
sane, and die prematurely, from this complaint, with-
out ever having dreamed of anything of the kind. In
general, too, their medical advisers are equally in the
dark, and go on attempting to cure the mere effects
while the grand cause of all is left untouched.
Spermatorrhoea, as I shall show further on, when
excessive, may produce symptoms similar to those
of almost every disease the system is subject to, and
thus lead to the belief that there is Disease of the
Heart, Liver Complaint, Dyspepsia, and a hundred
other affections of which there is in reality no trace
whatever. It may also materially impair the pow-
ers of the mind, or prevent their proper manifesta-
tion, and so change the feelings and disposition that

EXCESSIVE SEMINAL LOSSES. 221

the individual can scarcely be recognised as the
same person, by his conduct.

The ravages of this destructive disease are not
confined to any particular class, age, or condition,
nor is it always a consequence of vicious conduct,
as some suppose, but on the contrary, it frequently
attacks the most virtuous and exemplary. Some of
the causes that lead to it may operate as well upon
the healthy and strong as upon the weak and sickly,
and attack the middle-aged married man, of tempe-
rate habits, as well as the licentious unmarried
youth. It is therefore of the utmost importance
that this destructive pestilence should be unveiled,
so that every one may know how to guard against
it and ward off its evils:

To understand why it is that Spermatorrhoea
leads to such manifold and diversified evils, it will
be necessary to refer to the Organic and Sympathe-
tic connexion between the Generative Organs and
the rest of the system. The intimacy and extent
of which is but little known, and consequently its
importance is not appreciated. In the former part
of the present work this connection is partially
shown, but it is necessary here to make it still
more manifest.

To a considerable extent the Genital Organs are
in direct connection with the Urinary, and in some
places the same parts are common to both. The
lower part of the large Intestine, or the Rectum, is
also in close juxtaposition to them, as may be
readily seen by referring to the Frontispiece, and
the description of the male system. Any disease,
therefore, which affects the Genital Organs is very
apt to derange them likewise, and it is quite possi-
ble that the secondary disease may be more severe

19*

222 EXCESSIVE SEMINAL LOSSES.

than the primary one. Every one knows that
diseases of the Bladder, Kidneys, Urethra, and
Rectum, are quite common, and frequently very
distressing, while the causes of them are often un-
discovered. In many such cases these diseases are
only symptoms, the primary trouble being sperma-
torrhoea.

The great cause, however, of the Genital Organs
exerting such a general influence over every part is
their intimate connection with the nervous system.
There is no other process carried on in the body
that requires so much nervous power as the forma-
tion and evacuation of the semen, and no other is
therefore so exhaustive of the vital energy. Even
in youth the amount of this power required is very
great, to effect the full formation of the Semenifer-
ous Glands ; in fact Nature seems to put forth so
much effort for this purpose that every other part
is stimulated at the same time, and thus the perfect-
ing of the Genital Organs is the means of develop-
ing the whole system.

This is the reason why those who are castrated
are always imperfect, both in body and mind, and
die early. If the Testes are removed there is no
other part for which nature will sufficiently exert
herself to stimulate the whole, and consequently
the development is only partial. Those who have
ever seen Eunuchs will have had sufficient proof of
this, but any one may observe the same thing in
mutilated animals. Compare the Ox with the Bull
for instance, or the entire Horse with the castrated
one, and it will be at once evident that the form of
the body, and the disposition, are completely
changed. Even in after-life the vital energy re-
quired to secrete the semen invigorates the whole

EXCESSIVE SEMINAL LOSSES. 223

system, and disposes it to a constant activity that
would otherwise not be exhibited. Men deficient in
this respect are never noted for their enterprize and
love of adventure, but are always inclined to be
calm, inactive, and retired, even when possessing
genius. Nearly all men of strong energetic minds
and daring dispositions are of warm temperaments,
or in other words have a plentiful secretion of
semen. It is therefore an essential and important
agent, both for perfecting the system in early life,
and also for rousing it to sufficient exertion after-
wards, and beyond doubt a deficiency or superabun-
dance of this fluid may exert a decided influence
on the character of the individual. In all proba-
bility many are dull and inactive from deficiency in
this respect, while many others are too impulsive
and restless from excess, and yet the truth is sel-
dom suspected. It is too much the custom with
Physiologists to regard only the brain, as being con-
cerned in the production of mental characteristics,
and to consider it as the sole fountain of that myste-
rious influence which is constantly exerted over
every part of the system. A truly philosophical
view of the subject will, however, I am confident,
show that there are other parts whose action should
by no means be overlooked, and among the most
important of these are the Genital Organs.

A due consideration of these facts explains the
the true philosophy of sexual indulgence, and shows
why licentious excess produces so many and such
severe evils. In a healthy state Nature goes on
supplying the necessary nervous energy, both to the
Testes and the rest of the system, till a superabun-
dance of semen is formed, and then there is expe-
rienced a desire for its emission, the gratification of

I

224 EXCESSIVE SEMINAL LOSSES.

which is, physiologically speaking, under such cir-
cumstances, both proper and healthful. It is in
fact only the expenditure of the overplus energy,
and does not in any way weaken or destroy. If,
however, by artifical excitement, or factitious de-
sire, the seminal emission occurs before this super-
abundance exists it becomes exhaustive, and seri-
ously impairs the vital energy. Indulgence should
therefore be allowed only when this overplus power
excites to it, and any man can easily tell when that
is by studying his feelings and experience, and by
not giving way to artifical excitement.

When the seminal emission occurs oftener than
nature properly provides for, the nervous energy
expended is no longer a useless superfluity, but a
portion of the common stock, and its abstraction ne-
cessarily weakens the power of the whole system.
For a time Nature can, by extra effort, supply the
deficiency thus produced, but if the excess be too
long continued this effort at last fails, and then
a general prostration ensues. The career and ulti-
mate end of any licentious debauchee will well
illustrate this, and should act as a timely warning
to shun the same evil path.

The reason why the victim of excessive seminal
discharge suffers from almost every ailing of body
and mind, will now be evident. The stomach can-
not digest, the heart cannot propel the blood, nor the
brain think, unless they are each supplied with a
due amount of nervous power, and if most of that
be expended in the production and evacuation of the
semen, of course they will be deficiently supplied,
and will consequently perform their functions
imperfectly. Here then we have the cause, in
such cases of Dyspepsia, Heart disease, dulness

EXCESSIVE SEMINAL LOSSES. 225

of the intellect, insanity, and a thousand other
'evils.

Besides this exhaustion of the nervous energy,
however, it is also probable, from observations
recently made, that the semen requires for its per-
feet formation some important and subtile elements
of the body, the abstraction of which, in too great
quantities, is highly injurious. It has been supposed,
and with considerable plausibility, that a part of the
seminal fluid is identical with some portion of the
train and nervous sutstance, and that this common
material is produced for the use of both respectively.
This explains why the mind is nearly always active
in those who are of a warm temperament, because
the brain is nourished by a part of the same mate-
rial which is produced to form the semen. It also
shows why the mind must suffer when the semen is
expended in too great quantity, because the very
substance the brain requires is that taken away,
and it suffers in fact from want of its proper nutri-
ment. In confirmation of this it has been stated
that the brain has actually been found toasted, and
softened, in many persons who have died from
licentious excesses, and I have myself observed the
fact, after death from Masturbation. In one case
especially, the color and consistence of the brain
was so remarkably different from those of a healthy
person that no one could fail to observe it ; it had
in fact the very same appearance as in many states
of disease, and I have no doubt but that in many of
these poor victims the brain is constantly in a state
of inflammation, or wasting away. This is proba-
bly the true cause of that distress in the head, dim-
ness of sight, and loss of hearing, that many of
these patients complain of, and which sometimes

226 EXCESSIVE SEMINAL LOSSES.

continues till they become deaf, blind, and insane.
This explanation of the way in which Sperma-
torrhoea produces such various evils, will make our
detailed account of its effects easily understood, and
will also make clear the philosophy of its proper
treatment, and what should be done for its preven-
tion.

CAUSES OF SPERMATORRHOEA.

There are undoubtedly many causes of Sperma-
torrhoea with which we are but imperfectly ac-
quainted, and probably many that are not yet sus-
pected. Mr. Lallemand remarks that " when it
occurs spontaneously, during sleep, in a healthy
and continent individual, it doubtless exerts a bene-
ficial influence on the economy, by freeing it from
a source of excitement, the prolonged accumulation
of which might derange the animal functions. In
these cases it has an effect analogous to that pro-
duced by the bleeding at the nose, during youth."
If, ' however, the discharge becomes excessive, or-
continues longer than the state that first produced
it, great evil may follow, as already shown. Pro-
bably the most frequent cause of Spermatorrhoea is
too frequent sexual excitement, especially in the
form of Masturbation. This leaves the organs in a
state of irritation which stimulates them to constant
activity, and makes them perfectly independent of
the will. At first the emissions are alway attended
by erections and pleasurable sensations, during
sleep, but in time they begin to occur without either
erection or sensation, and finally take place in the
day-time, whenever the bowels are moved, or the
urine passed, and in extreme cases there is a con-
stant running away of the semen without any in-

EXCESSIVE SEMINAL LOSSES. 227

termission. To understand the reason of this
constant and uncontrollable escape of the semen, I
must refer to some of the Anatomical details given
in the description of the Male Organs. It was there
shown that the semen passes, from the Testes, along
a pipe or duct, called the Vas Deferens, which
opens into the Urethra, through the Prostate Gland,
by two little mouths called the Ejaculatory Ducts.
These mouths are always shut in a healthy state,
except under the influence of sexual excitement, and
then they open to let the semen through, but after-
wards firmly close. If, however, they are called
upon to do this too often they become irritated or
relaxed, and consequently are more disposed to open
from slight causes and have less power to close
again. They are especially liable, when irritated, to
be acted upon by the urine, which passes over them,
and as the bladder itself soon partakes of the same
irritation the urine is being constantly passed and is
nearly always mixed with semen. The pressure of
the Rectum on the Prostate Gland, when the bowels
are moved, will also cause the ducts to open, and
this is the reason why many persons always lose
semen when at stool. The ordinary motions of the
body even will do the same, in bad cases, and more
especially riding, running, leaping, or coughing.
Finally, the ducts entirely lose the power of closing,
from relaxation and then the semen is c©nstantly
dribbling away.

Whenever the semen can be seen there can of
course be no mistake as to the nature of the trouble,
but very often it flows involuntarily without being
visible, as before stated, and thus the individual
may suffer without its being suspected what from.
The manner in which this occurs will now be un-

228 EXCESSIVE SEMINAL LOSSES.

derstood, — the ducts become sensitive to the touch
of the urine, which in a healthy state produces no
effect upon them, so that every time that fluid passes
they open and allow the semen to escape along with
it. The Bladder itself being irritable also, owing
to its intimate connection with the diseased parts,
the urine cannot be long retained ; the smallest
quantity causes an irresistible desire to expel it, and
thus the individual is constantly urinating, and con-
stantly passing semen at the same time. It is only
very recently that this fact has been ascertained,
and doubtless numbers have died in this way, as
before remarked, without the slightest suspicion
beinor excited as to the cause of their death. The
means by which this mode of seminal escape is as-
certained are simple and sure, in practised hands,
as I can testify from abundant experience. They
consist in examining the urine with a properly con-
structed microscope, which exhibits in it the pre-
sence of the seminal animalcule. These mrnute
animals are nearly always to be found in the urine
of those afflicted with Spermatorrhoea, and their pre-
sence of course proves the escape of semen beyond
a doubt. — It is quite common for patients to remark
that the urine is thick and ropy, particularly the
last drops, and it is usually thought that this arises
from inflammation of the Bladder, but in most cases
it is only from being mixed with semen. In this
way I have been able to ascertain the true nature
of a person's disease in numerous instances, and to
apply the proper remedy, where previously they
had been treated only for some symptom of that dis-
ease, and of course without any permanent benefit.
Many times I have had respectable married men,
of temperate habits, come to me with every symp-

EXCESSIVE SEMINAL LOSSES.

torn of Spermatorrhoea, but who assured me that
they had never been troubled with anything of the
kind. They judged so, simply because they never
saw anything pass from them, and they did not know
that it could occur in any hidden form. On show-
ing these people the semen in their urine they were
amazed, and deeply regretted the want of informa-
tion that had prevented them from knowing the
cause of their suffering before. I have no doubt
but that this hitherto undetected form of Spermator-
rhoea has been the cause of incalculable misery to
thousands, and that it has condemned numbers to
insanity and untimely death.- — It is perhaps neces-
sary to remind the reader here that when the loss
occurs in this way it is from the ducts being irrita-
ble, and not from being relaxed. When really re-
laxed or open, the semen escapes at all times, from
various causes, or perhaps without any accidental
cause whatever.

It was remarked above, in speaking of the causes
of involuntary seminal emissions, that it probably
arose most often from too frequent sexual excite-
ments, especially in the form of masturbation. It
may be as well to remark, however, to avoid mis-
apprehension, that too frequent excitement in any
form may act in the same way. There are un-
doubtedly many married men who much exceed the
bounds of true moderation, and they are apt to think
that no harm will follow from such excess, because
it is legitimate. This is a great and a fatal mis-
take ; such men are just as liable to sufFer as if their
gratification was sought under any other circum-
stances, and I very often have such come to me for
advice. The Physiological Laws, by which health
is maintained, are quite distinct from those moral

20

230 EXCESSIVE SEMINAL LOSSES.

enactments demanded by the welfare of society;
and the observance of one of these can never give
immunity for the infringement of the other.

It is. not, however, excessive indulgence only that
will cause Spermatorrhoea, for the very opposite of
it may do the same. There are few men of warm
temperament, if healthy, that can remain long strictly
continent without having involuntary emissions dur-
ing sleep. These, as before remarked, are sanitary
efforts of nature to relieve herself, and when not too
frequent may be beneficial rather than hurtful.
Unfortunately there is always a tendency, if the
continence continues, for them to become more fre-
quent, so as eventually to constitute a real disease,
and thus many a virtuous young man, who has never
indulged in any form, is subject to the same misfor-
tunes as the licentious debauchee or the victim of
masturbation. This is a truth as important to be
stated as any other, though its announcement may
seem strange to those who hear it for the first time.
— There are fortunately many means that can be
used, in such cases, to lessen this tendency to an
undue increase of the discharge, and therefore these
persons should know of their danger, in order that
they may see the necessity for adopting such means.
Over-exertion or great agitation of the mind will
also cause Spermatorrhoea, owing to the sympathy
between the genital organs and the nervous sys-
tem, and it is frequently produced in this way in
merchants, students, professional men and others.
I have known many men of business who always
had involuntary emissions when they were much
troubled about their affairs, and several law students
have assured me that after any unusual application
they suffered in the same way. — Many other dis-

EXCESSIVE SEMINAL LOSSES. 231

eases of the generative organs will likewise lead to
Spermatorrhoea, and so will certain derangements
of the neighboring parts, particularly long-continued
constipation of the bowels, piles, and gravel. Cer-
tain medicines also, especially Cantharides, Phos-
phorus, Iron, and Opium, are very apt both to
produce and aggravate it, and so will the use of
Tobacco, Alcohol, and heating or highly-seasoned
food. — Among occasional causes, still less likely to
be suspected than any above referred to, may be
mentioned worms in the rectum, various skin diseases,
and diseases or injuries of the brain. Venereal
and Gonorrhceal affections also leave a tendency to
Spermatorrhoea, and often directly produce it. — I
have become satisfied also that in many children
there is a predisposition to it, inherited from their
parents, which is likewise accompanied in many
cases with a congenital weakness of the parts, which
is frequently denoted by incontinence of urine. —
All these causes will, however, be illustrated in the
" cases" which will be given further on. — The most
frequent cause, however, is sexual abuse, though it
may not assume a very aggravated form till many
years after; the follies and vices of youth being
thus, in many instances, the originators of disease
and misery in mature life.

PARTICULAR EFFECTS OF SPERMATORRHOEA.

The general effects already described may follow
from great seminal loss occurring in any way, but
when that loss is involuntary their effects are
usually more severe, and several others are also ex-
perienced that do not always accompany voluntary
indulgence, even when excessive. In fact involun-

232 EXCESSIVE SEMINAL LOSSES.

tary loss is generally indicative of extensive and
confirmed disease, and of course its symptoms are
most severe. -

Some of the first effects are exhibited upon the
parts more immediately connected with the Genitals,
particularly the Urinary Organs. The irritation
speedily extends from the Ducts and Yas Deferens
to the Urethra, and finally to the Bladder, which
becomes in consequence so sensitive that it cannot
retain the smallest quantity of urine without in-
convenience. The patient is therefore constantly
desirous to urinate, though but little fluid escapes
when he does so, and is thus kept in a state of con-
tinual annoyance, so that he dislikes to join com-
pany, or to go anywhere in public, for fear that he
should not find opportunities for relieving himself.

I have known men made completely wretched in
this way, and in one case, very recently, the indivi-
dual was compelled to give up a profitable and,
pleasant occupation, merely because he could not
remain at his post sufficiently long at a time. Ul-
timately this irritation may become so bad that all
voluntary power over the bladder is lost, and the
urine then escapes constantly, without the patient
being able to control it. This irritation of the
bladder is usually one of the first indications that a
man has exceeded the bounds of moderation, though
it does not always occur, even in the most con-
firmed cases of involuntary emission.

When the irritation has existed long in the Blad-
der it is apt to extend along the Ureters to the Kid-
neys, and produce there all the symptoms of
inflammation of the Kidneys, and of Gravel, with
great weakness and pain in the back. It is difficult
to convince many patients that they have not these

EXCESSIVE SEMINAL LOSSES. 233

diseases, and still more difficult to show them, when
they are uninformed, how their troubles really
arise. In fact I have known numerous cases where
physicians themselves have been deceived, and
where they have prescribed for these mere symp-
toms, supposing them to be the primary disease,
without ever suspecting the truth.

Another part very apt to suffer from Sperma-
torrhoea is the Rectum, or large intestine, which is
in direct communication with the Prostate Gland
and Seminal Vesicles, as may be seen by the
Frontispiece. In some persons there is a constant
feeling- as if the bowels were about to be moved,
with a bearing down sensation, and a partial pro-
trusion of the Intestine. In others there is a gene-
ral uneasiness around the Anus and Perineum,
which causes the patient to be continually shifting
about on his seat, and moving as if he were in pain.
Occasionally there is considerable irritation, or
itching, and very often severe Piles, from the cir-
culation of the blood being impeded. In short the
Rectum may be affected in many different ways,
and so may the rest of the intestines, from their
connection with it. Sometimes there will be a par-
tial paralysis of their muscles, from the deprivation
of nervous power, which, by arresting the peristal-
tic motion will cause obstinate constipation. At
other times the mucous coat partakes of the general
irritation, and ' then we have Diarrhoea exhibited,
and no medication whatever can check it so long as
the Spermatorrhoea continues.

Another symptom of Spermatorrhoea, sometimes
met with, is a peculiar irritation of the Urethra,
and Meatus Urinarius, or external opening from the
Penis. This irritation is sometimes very slight, and

20*

234 EXCESSIVE SEMINAL LOSSES.

only experienced after urinating, but at other times
it becomes quite severe, and pretty constant, resem-
bling in fact a real Gonorrhoea, and being even
accompanied by a discharge, showing the existence
of inflammation. Many men have become much
alarmed from this symytom, supposing it to be an
infectious disease, and in several instances I have
known it the cause of mutual suspicion and much
domestic unhappiness.

These local effects are usually the precursors of
more general and severe ones, the connection of
which with the true cause of all it becomes more
difficult to trace. In addition to a universal lassi-
tude and weakness there is experienced a remarka-
ble loss of power in the lower limbs, owing to which
the patient finds it impossible to walk far, or to
stand long upon his feet, without being overcome
with weariness, and feeling numbed in the legs and
thighs. The slightest exertion makes him tremble
and look pale, his heart flutters, or stops beating
altogether, and he experiences a tendency to faint.

This distressing debility is sometimes so exces-
sive that the individual becomes almost unable to
move, and yet he may not be much fallen away,
nor look veiy sick, so that uninformed persons are
apt to think it is mere idleness, or pretension. In
the course of time, however, the stomach begins to
suffer, and becomes so weak that digestion is imper-
fectly performed, and then emaciation follows,
which sometimes becomes a complete and rapid
wasting away. The loss of nervous power some-
times affects the Diaphragm more especially, and
then there is great difficulty in breathing, which,
with other sensations, leads to the belief that the
Lungs are diseased. And when this occurs along

EXCESSIVE SEMINAL LOSSES. 235^

with palpitation of the heart, which originates much
in the same way, the poor patient is in a state of
constant worriment and fear, nothing being able to
convince him that he has not Consumption and
Heart disease all at once.

The head is not exempt from the general influ-
ence, and headache, rush of blood, dizziness, and
constant drowsiness are commonly complained of.
Partial dimness, or loss of sight, is also frequently
observed, as if a cobweb had been spread over the
eye, which fills with water, and looks red, on the
slightest extra use of it. The eyelids, however,
are more disposed to inflammation then the eye
itself, and it is impossible to do them any good
while the Spermatorrhoea exists.

The most marked effects, however, are exhibited
in the mind and feelings. Mental activity becomes
as difficult and unpleasant as bodily, and the patient
becomes dull, listless, and moping, his memory
fails, his judgment weakens, and all power of ap-
plication seems lost. When he sits down to study
anything the powers of the mind appear to wander,
so that he cannot bring them to bear on the desired
point, and often he wakes up from a kind of dream
and finds that he has quite forgotten the subject
altogether. This listless abstraction often gets so
bad that the individual is unfit for business of any
kind, and not unfrequently it degenerates into insa-
nity. I have known several instance of men failing
in their business from this cause, and I have no
doubt but that it is oftener connected with human
mistakes and errors then people suppose. In youth
especially this effect is a very serious one, and the
bright prospects of many a promising young man
have been crushed in this way, without either him-

236 EXCESSIVE SEMINAL LOSSES.

self or his friends, perhaps, being able to tell the
cause. If the records of College and business fail-
ures, and of our lunatic asylums, could all be
properly written, the number of victims in each
who have been made so by this disease would
astonish every one. And probably we rriay add
also that moral failing has not unfrequently had the
same origin.

The feelings and dispositions of patients of this
class, in most cases, undergo as decided changes as
their mental powers, and equally to their disadvan-
tage, Sometimes they become melancholy, and
sensitive, to such a degree that they burst into tears
from the slightest cause, and constantly think they
are purposely subjected to trials and insults that no
one around them dreams of. At other times they
become irritable and peevish, keeping all around
them in as great a state of irritation as themselves,
and firmly believing they are the most ill-used peo-
ple in the world. Occasionally there is some pe-
culiar form of Monomania exhibited, one person
believing that he is constantly pursued by some
enemy, who wishes to deprive him of his life or
fortune, while another as firmly believes that some
terrible misfortune is about to overtake him, from
which he can by no effort whatever escape. It is
but seldom there is any tendency to violence exhi-
bited, at least towards others, the powers being too
much depressed, but sometimes the patient will in-
jure himself. Many instances are on record of
monomaniacs, of this class, castrating themselves,
under the idea that they could never be better while
the Genital Organs remained. In general there is
a decided aversion to the opposite sex, and a shy-
ness and embarrassment in approaching them.

EXCESSIVE SEMINAL LOSSES. 237

Many reputed hermits and woman-haters have been
men of this kind.

In short there is no end to the abberrations and
vagaries of mind and feeling induced by continued
Spermatorrhoea, as will be evident on reading the
following cases, which will better exhibit the pecu-
liar features of these cases than any mere general
description.

There is one melancholy effect of this disease oc-
casionally seen which I would willingly pass over,
if it were not necessary to disclose the whole truth,
so that the real extent of the evil may be seen.

The effect I refer to is a tendency to unnatural
habits and vices, which in such cases Charity bids
us look upon as resulting from a diseased brain,
sympathizing with the derangements of other parts.

The following cases are selected partly from My
own Note-book, and partly from M. Lallemand's
celebrated work, " Des Pertes Seminales.''''

Case 1. (Communicated by Dr. McDougall, in
the preface to his Translation of Lallemand.)

" R~ H , get. thirty-nine, passed the early

part of his life in the country, and was in the habit
of taking much and violent exercise. About the
age of sixteen, he entered a banking establishment
in London, in which by great diligence and steadi-
ness of conduct he rose before he was twenty-five,
to the post of cashier. The affairs of the house
fell into disorder, and ultimately a bankruptcy oc-
curred ; Mr. H , from the amount of confi-
dence reposed in him by the partners of the firm,
was much harassed during these unfortunate pro-
ceedings. Soon afterwards he became manager of

238 EXCESSIVE SEMINAL LOSSES.

a large mercantile establishment in the city, and
about this time commenced some speculations in
foreign bonds. From fluctuations in the share mar-
ket he was a loser to a considerable extent; his
mind was much harassed and he began to suspect
those about him of dishonesty towards their employ-
ers. On investigation these suspicions were proved

to be totally unfounded ; Mr. H gave way

to great violence of conduct, and resigned his situa-
tion. About this time his father died ; and Mr.

H was much disappointed at finding that

property, which he had incorrectly believed entailed
and consequently his, as eldest son, was left by will
to be equally divided between himself and the rest
of his family. His conduct at this period was of
the strangest description. He dreaded to go out
into the streets of the town where his family resided,
refused to join in their meals, and ultimately
abruptly left their house to return to London. In
1837, his state had become such that in consequence
of his repeated letters, members of his family vi-
sited London, and on their return took him with
them into Devonshire. About this time his mental
disorder put on a decided aspect ; and I had then,
as well as later, ample opportunities of observing
his conduct ; and frequently heard his complaints.
Emissaries were constantly on the search for him
to arrest him for unnatural crimes committed in
London ; every one who met him in the street, read
in his countenance the crimes he had committed ;
tailors made his coats with the sleeves the wrong
way of the cloth, in order to brand him with in-
famy ; the sight of a policeman in the street alarmed
him beyond measure ; and often, if a stranger hap-
pened to be walking for some little time in the same

EXCESSIVE SEMINAL LOSSES. 239

direction as himself, he would exclaim that he was
one of the emissaries sent to seize him. At other
times he would lock himself in his room and weep
by the hour. He never took his meals with the fa-
mily, and never tasted food or drink, without first
preserving a portion for chemical analysis, as he
was convinced his friends were in a conspiracy to
poison him slowly, in order to wipe out the memory
of his crimes. These ideas haunted him night and
day. His digestion was much disordered ; his sleep
broken and restless, and his bowels excessively con-
stipated. His face was flushed, and periodical at-
tacks of cerebral excitement occurred, during which
he complained of vertigo, noise in the head, loss of
sight, &c. He complained also of loss of memory,
and frequently of bodily weakness, and lassitude.
The best medical advice the neighborhood afforded
was obtained, unavailingly ; the opinions of the gen-
tlemen consulted, were that Mr. H ■ — was labor-
ing under aggravated hypochondriasis, complicated
with monomania. Various causes were suggested
as giving rise to the disorder, but no previous case
of insanity was recollected in any branch of the
family. Mr. H — ■ now began to talk of leav-
ing England for America, in order to avoid his per-
secutors; and to prevent this he was placed under
the care of a private keeper. While with this per-
son he frequently and bitterly complained of con-
stant pollutions while at stool, with darting pain, and
a sense of weight between the rectum and bladder.
He had also urethral irritation attended with dis-
charge, pains in his loins, and in one groin, weak-
ness of his legs, thick urine, piles, and obstinate
costiveness. He kept a (Mary at this time, which is
at present in my hands. Not a day is passed in this

240 EXCESSIVE SEMINAL LOSSES.

diary without mention of the distressing seminal
discharges from which he suffered. These were
treated as of no importance by his medical attend-
ants, although he never ceased to complain of them,
and solicited aid so long as he continued in confine-
ment in England. When led away from his disor-
der into any discussion on public matters, he was,
however, a most amusing and instructive compa-
nion ; as a man of business he was equally acute,
and to a stranger as long as nothing was done to
offend him he was, to all appearance, a man of ob-
servation and experience in life. For about two
years and a half he was under the care of various
gentlemen, devoted to the insane, and at length he
was discharged from an establishment near Bath, by
the visil.ing magistrates, as a person confined with-
out due cause. His first act was to commence legal
proceedings against his friends for his detention,
and having gained his action, he immediately pro-
ceeded to London, and waylaid and violently as-
saulted a gentleman of high commercial standing in
the city. After this offence he was confined for a
considerable period in default of bail, and imme-
diately on his liberation it is believed that he pro-
ceeded to America. From this time nothing Was
heard of him until September, 1843, when a letter
was received by a gentleman who formerly attended
him, in which he stated that the same course of per-
secution was pursued towards him in America, as
had been followed in England. He complained of
not being able to obtain efficient medical treatment,
although he had applied to the most eminent practi-
tioners at Cincinnati, and afterwards at Philadel-
phia and New York. After this, nothing more was
heard of Mr. H until the year 1845, when

EXCESSIVE SEMINAL LOSSES. 241

an American newspaper was forwarded to his friends
by an unknown hand, containing an account of his
death, and of an inquest held on him headed ' Death
of a Hermit in West Jei'sey.' It was stated that
he had lived on a small farm, entirely alone, with
the exception of a dog, and that he had shunned all
intercourse with his neighbors. He was taken sud-
denly ill, applied to a neighboring farmer for assist-
ance, but died in the course of the following day.
From information subsequently obtained by his
friends, it is believed that he died of apoplexy, or
perhaps, in one of the attacks of congestion of the
brain, from which he frequently suffered before he
left his native country.

" The symptoms of this unfortunate case strongly
resemble those of the thirty-second and fifty- sixth
cases related by M. Lallemand. It was more ag-
gravated, however, and presented the somewhat un-
common feature of the patient's discovering the
frequent pollutions, and constantly complaining of
them ; these, unfortunately, were treated as matters

of no importance. Mr. H 's insanity at first,

constantly had reference to his having either com-
mitted or been accused of committing unnatural
crimes, and this idea never entirely left him, al-
though during the latter part of his life, his more
prominent hallucinations had reference to imagin-
ary persecutors constantly watching him, and endeav-
oring to ruin him by spreading false reports, and
to poison him by adulterating his food, and infusing
noxious gases into the air. There can be little
doubt, on taking into consideration his complaints
of weight between the rectum and bladder, with
darting pains, &c, in the same region, that the pol-
lutions arose from irritation in the neighborhood of

21

242 EXCESSIVE SEMINAL LOSSES.

the prostate ; and I think, that if at an early period
of his disease this had been relieved, there would
have been considerable hope of his recovery from
the hallucinations he manifested."

This case I have selected as one that gives a great
number of the symptoms usually observed, and as
being well calculated to give a correct idea of the
immense series of evils that often follow from this
disease. The next case is also one of Dr. McDou-
gall's, and is equally instructive. It is a perfect
copy of numbers that have come under my notice.

" The other case to which I have alluded as par-
ticularly attracting my attention, and which came
under my notice about the same time, was that of a
young man of high intellectual power and general
talents, studying medicine. This gentleman was
one of my most constant companions, when almost
suddenly, a serious change came over him — he
shunned society, especially that of females, was
morose, taciturn, and frequently shed tears ; he sat
sometimes for hours in a kind of abstraction, and on
being aroused from it he could give no explanation
of his thoughts and feelings ; he constantly ex-
pressed to me his conviction that he should never
succeed in his profession, and frequently exclaimed,
that he was ruined both here and hereafter — body
and soul — and by his own folly. About twelve
months previous to this depression of spirits, he had
a very severe attack of blennorrhagia, with orchitis
and phymosis. This left a degree of irritability in
the bladder, which required him to pass urine fre-
quently. His digestion became so. disordered that
the simplest food would not remain on his stomach,

EXCESSIVE SEMINAL LOSSES. 243

and he had frequent eructations of fluid, which
blazed like oil if spit into the fire. This gentle-
man's father was a physician, and being naturally
anxious for his son, obtained for him the advice of
many of the most eminent of the faculty. No im-
provement took place however. After he had been
six months in this state, I had an opportunity of
spending three weeks by the sea-side, and my
friend accompanied me. We slept in the same
room, and he was scarcely ever out of my sight.
Before our return, his health was almost re-esta-
blished, and his spirits had returned to their natural
condition. Twelve months later, however, he again
fell into the same state of despondency, and this
time his condition was much worse than on the for-
mer occasion. He frequently remained in bed three
parts of the day, and no threats or entreaties on the
part of his father, could induce him to get up. His
intellectual faculties were totally prostrated, and a
vacant stare, which took the place of his natural
lively expression, induced considerable fears of his
ultimately becoming idiotic. I was the only person
who possessed any influence over him, which may
perhaps be attributed to his feeling that I was
aware of the cause of his disorder. This state
continued between three and four months, during
which time I was with him as much as my other
duties would permit, and frequently showed him the
folly of the course he pursued. At the expiration
of this time he gradually recovered. He has since
had a slight relapse once only ; he has pursued his
professional studies with success, and is at present
a medical officer in her Majesty's service.

On this case, I need not only remark, that the
symptoms did not arise from involuntary seminal

244 EXCESSIVE SEMINAL LOSSES.

discharges, but from excessive discharges caused by
abuse. The various treatment recommended by
the distinguished practitioners consulted, proved un-
successful, because the origin of the disorder was
unrecognised, and the remedies consequently use-
less, while the habits of abuse were continued."

The following case is one of M. Lallemand's,
and is chosen here as an illustration of the fact,
already stated, that this disease may exist and be-
come very serious, in " married persons. It also
shows how physicians may easily mistake the
symptoms for those of other affections.

"In the month of January, 1824, I was requested
to see M. De S , affected with symptoms of ce-
rebral congestion, from which he had suffered for
some time. During several consultations I gathered
the following facts.

" M. de S was born in Switzerland of healthy

parents, and his father died suddenly of affection of
the brain. M. de S , possessing a strong con-
stitution and an active mind, received an excellent
education, and at an early age turned his attention
to the study of philosophy and metaphysics ; he
afterwards studied moral philosophy and politics.

" After having spent some years in Paris, pursu-
ing his favorite subjects, he was obliged to under-
take the management of a manufactory, and to
attend to details which wounded his pride. He
became, by degrees, peevish and capricious — passed,
without apparent cause, from an extravagant gaiety
to a profound melancholy — was irritated by the
slightest contradiction — showed no pleasure at for-
tunate events — and gave way to anger on improper

EXCESSIVE SEMINAL LOSSES. 245

occasions ; at length he appeared to feel disgust and
fatigue at correspondence or mental exertion.

" At this period he married, and Dr. Butini of
Geneva, 'his medical attendant and friend, wrote
respecting him as follows : —

" With this marriage the most happy period of
his existence seemed to commence ; but soon the
germs of the disease, which so many causes had
contributed to produce, became rapidly developed.

It was perceived that M. de S wrote slowly

and with difficulty, and his style presented signs of
the decay of his faculties ; he stammered and ex-
pressed his ideas very imperfectly ; he experienced,
also, at times, attacks of vertigo, so severe as to
make him fall, without, however, losing sensibility,
or being attacked by convulsions.'

" One day an attack which frightened the patient
seriously, and left a deep impression on his family,
came on whilst writing an ordinary letter. His
medical attendants attributed this attack, which left
a weakness of the right side of the body, to apo-
plexy. Twenty leeches were applied to the anus,
and the danger seemed at an end.

" Similar attacks, however, occurred at Geneva,
Montpellier, and several distinguished practitioners
were consulted : some of these, struck by the misan-
throphic irritability of the patient, and his solitary
habits, regarded the affection as purely hypochon-
driacal or nervous ; others, taking into consideration
his digestive disorder, considered it an affection of
the liver ; but the great number were of opinion
that there existed a chronic affection of the brain,
such as encephalitis, or chronic meningitis, arising
from hereditary predisposition. This last opinion
was held by Dr. Bailly, (of Blois).

21*

246 EXCESSIVE SEMINAL LOSSES.

" At all these consultations, the necessity of ab-
staining from serious occupation, the utility of trav-
elling— of various amusements, and of a strict regi-
men— and the importance of free evacuafions from
the bowels by means of purgatives and injections —
were agreed on. Many of the practitioners recom-
mend the frequent application of leeches to the anus,
with milk diet, &c. ; others thought that assafoetida,
baths, and camphor, were indicated.

" None of these modes of treatment produced any
considerable amendment ; the leeches weakened the
patient, and the milk diet disordered his stomach.
His constipation continued. Cold plunge baths, and
cold effusion to the head, relieved the insupportable

spasms M. de S experienced in his legs and face ;

the waters of Aix, in Savoy, and the use of douches
also appeared to produce some improvement.

" Still M. de S became more irritable, and

at the same time more apathetic. His attacks were
more frequent and more violent, and he manifested
greater indifference towards the persons and things
he had before been partial to. The weakness of his
limbs increased to such an extent that he frequently
fell, even on the most level ground. His nights
were restless, his sleep very light and often inter-
rupted by nervous tremors, or acute pains accompa-
nied with cramp. The cerebral congestion in-
creased, and the imminent fear of apoplexy rendered
leeches to the anus, venesection in the foot, tartar-
emetic ointment, blisters, mustard pediluvia, and the
application of ice to the head, necessary.

" Notwithstanding the employment of these ener-
getic measures, another violent attack of congestion
occurred. I was summoned on this occasion, and I
found the patient restless, agitated, and incapable of

EXCESSIVE SEMINAL LOSSES. 247

remaining two minutes in the same place ; his face was
red, his eyes projecting, injected, and fixed, his phy-
siognomy expressed extreme dread ; his walk was
uncertain, his legs bending under the weight of his
body ; his skin cold, and his pulse small and slow.

" The last circumstance attracted my attention,
and I also recommended the application of leeches to

the anus. M. de S immediately threw himself

into a violent passion and asserted that leeches had
always weakened Mm without giving Mm any relief.
I was too much afraid of the occurrence of apo-
plexy to pay attention to this assertion, and I suc-
ceeded in obtaining the application of six leeches.

" The next day I found tbe patient very pale, and
so weak that he was unable to walk — a source of
much annoyance to him, as he manifested a con-
stant desire for motion. An oedematous swelling
of the parotid gland and of the right cheek followed,
which was succeeded, a few days after, by a similar
state of the left leg and foot.

" Sleep had become indispensable, and the patient
was much reduced from the want of it; he told me
with tears in his eyes, that he had lost his appetite,
and could no longer relieve his bowels. I also
learned that he was habitually costive and flatulent ;
that he often had recourse to injections and purga-
tives in order to relieve his obstinate constipation ;
and, lastly, that his walks, and the evacuation of his
bowels had lately become the sole objects of his
thoughts and conversation.

" Having observed analogous symptoms in almost
every person affected by diurnal pollutions, I made
further inquiries respecting the attaek, in which it
was supposed that the right side had been paralyzed,
and I was soon convinced that the intellectual pow-

248 EXCESSIVE SEMINAL LOSSES.

ers had been wanting, and not the power in the hand
which held the pen : both sides of the body had, in
fact, retained an equal degree of strength.

" Struck by a remark of Dr. Butini's respecting
the progress of the disease soon after marriage, I

made inquiries of Mine, de S , and learned that

the character of her husbaud had become so un-
certain, irritable, and tormenting, that his friends
thought he must be unhappy in his marriage. I
then suspected that the origin of the patient's dis-
ease had been mistaken, and I requested that his
urine might be kept for my inspection. The ap-
pearance of the urine was sufficient to convince me
that my suspicions were well founded ; it was
opaque, thick, of a fetid and nauseous odor, resem-
bling that of water in which anatomical specimens
have been macerated. By pouring it off slowly, I
obtained a flocculent cloud, like a very thick decoc-
tion of barley ; a glairy, ropy, greenish matter re-
mained, strongly adherent to the bottom of the vessel,
and thick globules of a yellowish white color, non-
adherent, like drops of pus, were mixed with this
deposit. I was therefore convinced that spermator-
rhoea existed, together with chronic inflammation of
the prostate and suppuration in the kidneys.

" Notwithstanding the state of M. de S 's in-
tellect, I was able at a favorable moment to obtain
further information. At the age of sixteen, he had
contracted blennorrhagia ; this he carefully con-
cealed, and succeeded in curing by the use of refri-
gerant drinks. The following year the blennorrha-
gia returned and was removed by astringents. Two
years afterwards, from drinking freely of beer when
heated, the discharge again appeared, and after some
time it again returned, from the effects of horse ex-

EXCESSIVE SEB1INAL LOSSES. 249

ercise. Since that time M. de S had felt little

sexual desire, and had abstained from intercourse
without regret. Ejaculation during coitus had
always been very rapid. Fully convinced by com-
bining all these circumstances, I explained to M. de

S the nature of his disease, and he promised

me to observe carefully.

"The next day he called me aside, and told me
that the last drops of urine were viscid, and that
during an evacuation of the bowels, he had passed
a sufficient quantity of a similar matter to fill the
palm of his hand.

" Eight days after, another attack of cerebral
congestion occurred, followed by stertorous breath-
ing, cold skin, and an inappreciable pulse ; the pa-
tient fell into a kind of syncope, of which he died on
the 1st of March, 1824."

Not long since I had under my care the Editor
of a Newspaper whose case was almost identical
with the one above, and who was first made sick, as
he informed me, by excessive agitation during an
Election Campaign.

Constipation has been spoken of as a cause of *
Spermatorrhoea, but few persons would suppose it
could have the effect that sometimes follow from it.
The next case, however, will convince the most skep-
tical, and though it is not often that we have such a
severe case, there are yet plenty that are bad enough.

" M. De B ! — consulted me in the month of

May, 1834, respecting a cerebral affection, on whose
nature distinguished physicians could not agree, but
which all regarded as very serious.

" He was of a middle height, with a large chest,

250 EXCESSIVE SEMINAL LOSSES.

and a well-developed muscular system ; his hair
brown and curly, his beard thick, his face full and
deeply colored. Notwithstanding these signs of ap-
parent strength and health, I noticed that his knees
were slightly bent, and that he was unable to remain
long standing without shifting the weight of his
body from one leg to the other ; his voice was weak
and husky ; the motions of his tongue seemed em-
barrassed, and he articulated his words in a con-
fused manner ; his attitude was timid, and his man-
ner had something of incertitude and fear ; he had
been married fifteen days.

" His mother-in-law and his young wife, who ac-
companied him, informed me that within this period
he had several attacks of congestion of the brain,
during which his face was highly injected. At the
first of these attacks the surgeon, called in the
night, had bled him to the extent of three pounds, in
order to prevent apoplexy ; repeated venesection, and
the frequent application of leeches, had relieved
such attacks of congestion, but had not prevented
their recurrence. The patient had become subject
to attacks of vertigo, and was unable to look up-
wards without feeling giddy ; his legs had become
so weak that he had fallen several times, even when
walking on level ground ; his ideas had lost their
clearness, and his memory failed rapidly.

" These symptoms had spread consternation
through both the family of my patient and that of
his wife, especially as several practitioners of repu-
tation were agreed as to the existence of some seri-
ous disease of the brain, although they could not
decide as to its nature. Most of them, however,
were inclined to suspect ramollissement. (Softening.)

" The countenance of the patient during this re-

EXCESSIVE SEMINAL LOSSES. 251

cital, the coincidence of the congestion, with the
period of his marriage, and the bad effects of blood-
letting, made me suspect the nature of the disorder,
and induced me to question the patient separately.
When we were alone he told me, stammering, that
an unexpected occurrence, immediately after his
marriage, had at first prevented any conjugal in-
timacy, and that afterwards he had found himself
completely impotent. He attributed this misfortune
to the attacks of cerebral congestion, and to the
bleedings he had undergone. On further inquiry,
however, I discovered that he was affected bv diur-
nal pollutions.

" The following is the history I obtained from this
patient by dint of questioning : — at the age of six-
teen, he possessed a very strong constitution, and an
ardent and passionate character. At school he
contracted the habit of masturbation, and at the end
of three months he had frequent nocturnal pollu-
tions, with pain in the chest and troublesome palpi-
tations, which warned him of the danger of the vice,
and he renounced it forever. When he became
free from the restraints of school, he subdued the
ardor of his temperament, by the most violent ex-
ercises— especially that of the chase — and he at-
tached himself to agricultural pursuits with much
energy^

" This new mode of life so completely re-esta-
blished his health, that he was tormented by ener-
getic, and continual erections, to subdue which, he
employed river-baths, even in the coldest seasons.
He never committed excesses of anv kind, and had
never suffered from any blennorrhagic or syphilitic
affection.

"In 1831, the erections were slightly mitigated.

252 EXCESSIVE SEMINAL LOSSES.

but he became very much constipated, which foe
attributed to the constant use of horse exercise.

" In 1832, he experienced some numbness and
creeping sensations in his feet and legs.

" In 1833, frequent dazzling of sight occurred
with vertigo, difficulty of vision, and flushes of heat,
towards the head and face, the patient attributed all
these symptoms to the effects of his still increasing
constipation.

At the same time that these symptoms occurred,
the patient's erections became rarer, less energetic,
and after a time, incomplete ; his fitness for intel-
lectual labour diminished ; the cerebral congestions
became more frequent, and more severe ; his face
became habitually very red ; his head burning ; an
almost constant fixed pain came on in the orbits,
and his character became fickle and contradictory.

" His family physician, attributing all these dis-
orders to a state of plethora, caused blood to be
drawn several times, without benefit.

" In March, 1834, M. De B engaged himself

to a young lady, who lived about two leagues from
his estate ; and in order to visit her without neglect-
ing the care of his property, he was obliged to
make long and frequent journeys on horseback ;
shortly before his marriage, these journeys became
so frequent, that he might be said to pass the greater
part of his time on horseback. His constipation
now increased to such a degree, that he passed forty
days without faecal evacuation ; during his efforts at
stool he passed semen in large quantities, and in
jets, although the penis remained flaccid. He had
previously, several times, noticed the same occur-
rence, but as he attributed it to his long-continued
continence, he paid little attention to the circum-

EXCESSIVE SEMINAL LOSSES. 253

stance, rfis urine was constantly muddy ; it was
passed slowly, and with difficulty, and threw down
a large quantity of thick and flocculent deposit.

" M. De B awaited the period of his mar-
riage with a vague uneasiness, of which he could
not imaoine the cause : he was much attached to
his betrothed, but, nevertheless, he experienced
more embarrassment than pleasure in her society.

" I have already stated what occurred after his
marriage, I should add, that having examined his
genital organs, I found them, contrary to my expec-
tations, of unusual development, the Testicles were
large and firm, but the scrotum was slightly re-
laxed. The patient experienced a strange tingling
in the organs, and at times felt as if they were com-
pressed by a hand of iron. These sensations in-
creased/ when near his wife, and the penis dimi-
nished in size, and became retracted towards the
pubes, in proportion as he endeavored to excite
erection.

" The union of all these circumstances could not
permit any doubt to remain on my mind as to the
nature of his disease ; it became evident that all
idea of cerebral affection must be abandoned, and'
that the diurnal pollutions, with all the symptoms of
which they were the cause, must be referred to the
patient's constipation.

" The first indication to be fulfilled, therefore,,
was to relieve the constipation ; indeed I hoped this
was all that would be necessary : the youth of the
patient, the development of his genital organs, and
the strength of his constitution induced me to sup-
pose that his cure would be prompt and easy.
Things did not, however, follow so simple a course.

" The next day the patient began to use ascendV
22

254 EXCESSIVE SEMINAL LOSSES.

ing douches ; and was put on a vegetable diet, with
iced-milk.

" The first douches caused the evacuation of an
immense quantity of fsecal matter in lumps, as hard
as bullets, and it was not until after the sixth douche
that the faeces were of normal consistence ; I then
caused the temperature of the water to be lowered
to 25° of Reaumur's* scale, and afterwards to 20°
Reaumur. t The last few douches were given at
16° Reaumur.:]: After the twelfth douche had been
administered, they were omitted, the bowels having
acted regularly every day, without the necessity for
the slightest straining..

" By this time the patient's countenance had lost
Its purple tint, and presented a more natural appear-
ance : the stunning sensations of which he had
complained diminished by degrees, and at length
disappeared entirely ; his legs regained their
strength, and he was able to continue in a standing
posture for a long time without fatigue, and to take
long walks without inconvenience; his voice re-
sumed its natural tone, his eye regained its expres-
sion, and all his motions acquired firmness.

" At the expiration of a fortnight the spermatic
discharges during defecation had ceased entirely ;
but. his urine still continued thick. His erections
had already acquired sufficient energy to make him
believe himself cured, but ejaculation took place
almost instantaneously. The use of ice and cold
lotions did not ameliorate his condition.

" Such was M. De B 's state at the end of a

■month ; when, in order to act directly on the orifices

♦ About 88° of Fahrenheit.
t About 81° of Fahrenheit.
\ About 6SQ of Fahrenheit.

EXCESSIVE SEMINAL LOSSES. 255

of the ejaculatory ducts, I determined to cauterize
the prostatic portion of the urethra. As soon as the
inflammation had subsided, his erections became
more perfect and energetic ; yet ejaculation still
took place too rapidly. The period for using the

mineral waters having arrived, I sent M. De B

to Aix, in Savoy, where I visited him shortly after.
He had experienced very little benefit from the use
of the waters, either externally or internally.

" I now prescribed douches, alternately very
warm and very cold, on the perineum and loins, the
spout being changed when the sensation, either of
cold or heat, became very intense. The bath was
ended after about twenty or twenty-five minutes, by
the cold douche, and the patient's skin remained
highly injected for some hours afterwards.

" The effects of these douches were conclusive ;
after the first, the patient's erections acquired a de-
gree of vigor and duration which reminded him of
his early torments. He continued the use of the
douches for some days after his re-establishment;
and when he left Aix the functions of his genital
organs were perfect. Ejaculation was a good deal
protracted by the use of the douches.

" I have entered into a somewhat lengthy detail
of this case, because the subject affects gravely the
most serious interests of society, as well as the
happiness and peace of families. Besides, I con-
fess that I was much interested by the unhappy
position of a young man whose misfortune was un-
deserved, and could not have been foreseen, as well
as by that of his wife — a young woman scarcely of
age, who was obliged to enter into the mest unplea-
sant details.

" It is evident that in the case of M. De B ,

256 EXCESSIVE SEMINAL LOSSES.

the constipation was the cause of the involuntary-
seminal discharges. The patient had practised
masturbation it is true, and nocturnal emissions fol-
lowed ; but he had continued the vice only three
months, and his health, though disordered for a
short time, was soon re-established by the use of
violent exercise. M. De B was even tor-
mented during several years by erections, which
must have been very energetic, if we may judge by
the means he took to subdue them. From this time
he had never committed any kind of excess, and he
had never suffered from either blennorrhagia or
syphilis. There is then no circumstance in the
history of his life, except his constipation, which
would account for the involuntary discharges.

" But to what is this constipation to be referred ?
After all I could learn from the patient concerning
his mode of life, I could only refer it to his constant
horse exercise. In fact, M. De B some-
times passed whole days on horseback, either for
the purpose of hunting, or of superintending the
management of his property. Shortly before his
marriage his rides became more frequent and
longer, and his bowels at this time did not act dur-
ing forty days. The weakness of his legs, the
stunning sensations, &c, increased in proportion as
his costiveness became more confirmed.

" This case recalls to my mind the well-known
observation of Hippocrates on the impotence of the
Scythians, and I have no doubt that his opinion was
founded on analogous facts. I shall treat this sub-
ject more fully in another place ; but since at pre-
sent I am considering the causes of Spermatorrhoea
which act on the seminal vesicles through the influ-
ence of the rectum, I report this striking case,

EXCESSIVE SEMINAL LOSSES. 257

•

showing the effects of long-continued horse exercise.

" M. De B — ; was accustomed to nutritious

food, and of a well-marked sanguineous tempera-
ment ; he had a large chest, powerful muscles, and
a highly injected countenance ; it is therefore by no
means extraordinary that he should have been bled
frequently for the relief of the cerebral congestions
to which he was subject. On the night of his mar-
riage the blood rushed to his head with greater
force than ever, so that an attack of apoplexy was
much feared ; the weakness of the legs, the frequent
falls, and the attacks of vertigo, were therefore
afterward attributed to an advanced stage of disease
of the brain. This was a very natural opinion, but
it was an incorrect one ; I doubted it from the com-
mencement, although the patient was brought to me
in consequence of a supposed cerebral affection. I
formed a different impression, because I had previ-
ously seen many analogous cases. There exists in
all these patients something peculiar in the expres-
sion of the eyes, in the position, in the voice, and
in the general appearance ; something of timidity
and bashfulness which I am unable to express, but
which is instantly recognised by the experienced,
although perhaps it is incapable of explanation.
However this may be, the relation of the above case
should draw attention to the subject.

" I admit that venesections seemed to be clearly

indicated in the case of M. De B , but the

loss of blood never produced good effects either im-
mediate or remote ; and by analyzing the case care-
fully, his attendants would have seen that under
this treatment the attacks increased in frequency.
But pre-convictions throw a thick veil over the most
acute perceptions.

22*

258 EXCESSIVE SEMINAL LOSSES.

# *

" The ascending douches put an end to the consti-
pation ; but freedom of fsecal evacuation did not
suffice to cure the disease. The seminal dis-
charges, during the passage of fseces, diminished,
indeed, or perhaps entirely ceased, but the patient's
urine remained thick and muddy, and his erections
were incomplete. The application of ice and of
the nitrate of silver, and the use of sulphurous
waters, were not sufficient to effect this cure ; yet
there could not have existed any organic change- in
his genital organs. We can therefore only attri-
bute the continuance of the seminal discharge,
during the emptying of the bladder, to relaxation of
the ejaculatory canals, produced by their long habit
of allowing the semen to escape in a passive man-
ner— showing how necessary it is to put an end to
the habit as early as possible."

The next case shows the effects of worms in the
Rectum, both in producing and keeping up the
Spermatorrhoea, and also in first leading to Mastur-
bation, in childhood.

" M. R , a student of medicine, enjoyed good

health in his childhood, but about the age of fifteen
was tormented by frequent and prolonged erections.
One evening, for the relief of the itching, of which
the extremity of the penis was the seat, he rubbed
the organ violently between his hands. This led to
the establishment of masturbation as a habit or
rather as a passion, the patient practising it some-
times as often as eight or ten times a day. His
health by degrees became so altered that one of his
friends suspected his practices, and told him the
dangers of his situation. By degrees he corrected

EXCESSIVE SEMINAL LOSSES. 259

himself, though not entirely before he had attained
his twentieth year. On his renouncing masturba-
tion, nocturnal emissions supervened, and often oc-
curred two or three times a night. They diminished
after a time, but without ceasing entirely, and semi-
nal emissions during defecation and the emission of
urine were added to them. Thus his health became
daily more and more disordered for nine years, not-
withstanding absolute continence, a severe regimen,
and the use of sedatives, tonics, and anti-spasmodics.
At length he grew incapable of any mental exer-
tion. In 1837, he came to Montpellier, at the age
of twenty-nine, in the following condition : — Ex-
treme emaciation ; face pale ; appearance stupid
and confused ; intellect dull ; reasoning powers
much affected, the patient being incapable of con-
necting two ideas on the most simple topic of con-
versation ; loss of memory ; constant headache re-
ferred to the forehead and temples, and increased by
any mental excitement, being then accompanied by
nervous tremors, and an almost idiotic state ; sleep
broken and unrefreshing ; constant sighing ; fre-
quent attacks of congestion of the head, especially
at night ; violent noise in the ears resembling the
sound of a waterfall ; vertigo ; stunning sensations
giving rise to a constant fear of apoplexy ; timidity
carried to a ridiculous extent ; panics of fear even
during the day ; character gloomy, taciturn, rest-
less, and irritable ; horror of the least noise, and of
all society ; irresistible restlessness ; great weak-
ness ; abundant sweats after very slight exertion ;
almost constant coryza ; frequent, dry and hard
cough ; pains in the base of the chest, the region of
the heart, and along the spinal column ; appetite vo-
racious ; dragging at the pit of the stomach \ difficult

260 EXCESSIVE SEMINAL LOSSES.

digestion, accompanied with the development of fla-
tus ; grinding of the teeth during sleep ; burning at
the point of the tongue ; darting pains in the bowels,
especially in the rectum ; obstinate constipation al-
ternating with violent attacks of diarrhoea ; stools
containing much mucus, and sometimes streaked
with blood ; periodical pains at the margin of the
anus, in the perineum, penis, and testicles ; urine
passed in large quantities, and very frequently,
always throwing down a whitish, thick, and very
abundant deposit, involuntary emissions during de-
fecation, both when constipated and relaxed ; fre-
quent and prolonged erections by day as well as by
night ; with constant presence of erotic ideas.

" On sounding this patient, [ found the urethra
very sensitive, especially towards the neck of the
bladder, and I consequently thought that the noc-
turnal and diurnal pollutions were kept up by a
state of irritation arising from masturbation. I
therefore proposed cauterization. This was per-
formed on the following day, and produced the usual
immediate effects, but its curative effects did not take
place as I had anticipated. I then directed the pa-
tient to notice his fseces, and a few days afterwards
he told me that he had observed numerous little
worms passed in his stools. I now ordered enemata
of cold water, and salt and water, which, however,
produced only a momentary effect — probably be-
cause the ascarides inhabited the upper part of the
intestine. A few doses of calomel however, caused
them to disappear without returning ; and from this
moment the involuntary diurnal emissions ceased
entirely, the nocturual emissions became more and
more rare, and the patient's re-establishment pro-
gressed very rapidly. M. R returned to his

EXCESSIVE SEMINAL LOSSES. 261

studies with ardor, and long afterwards all functions
were perfectly well performed.

" It appears evident that the irritation caused by
the ascarides, in the rectum first led this patient to
practise masturbation, and afterwards kept up invo-
luntary seminal discharges. I did not discover this
at first, because the history of his case, sent me by
the patient, was so long, and was characterized by
such disorder and want of clearness, that I was
unable to arrive at any satisfactory conclusions from
such a chaos ; his answers were still more vague
and unconnected, so that my attention had been
chiefly attracted to the state of his intellect, and the
abuses he had committed. But after seeing the
little success of cauterization, and again reading
his notes, I paid more attention to the circumstances
attending the commencement of his practising mas-
turbation, and I noticed several symptoms to which
I had not before attached importance, such as grind-
ing of the teeth during sleep ; burning pain in the
point of the tongue ; pain in the rectum, and at the
margin of the anus ; the stools always containing
mucus, and sometimes being streaked with blood ;
and especially the frequency and duration of the
erections, and the constant presence of erotic ideas."

I have met with many instances in which great
irritation of the Genitals was produced by worms,
and I have no doubt but that the tendency to Mas-
turbation is often caused by them, in both sexes,
a fact that parents should bear in mind.

That the tendency to Spermatorrhoea is often
hereditary, I have no doubt, and I have met with
some remarkable proofs of it in the course of my
practice, but as they are not of a nature to be

262 EXCESSIVE SEMINAL LOSSES.

readily understood by those not accustomed to ob-
serve them it is not necessary to give the details. I
have known many instances of brothers, in one
case of jive, all of whom suffered from excessive in-
voluntary emissions, at the same age, and without
being addicted to abuses of any kind.

Peculiar congenital predispositions often exist,
particularly in those of a nervous character, though
few practitioners are aware of their real extent.
M. Lallemand gives some excellent illustrations of
these kind of cases, and I can select many such
from my own note-book. The following will, how-
ever, be sufficient.

" In general such patients were of sickly con-
stitution and more or less marked nervous tempera-
ment, they had been delicate from childhood, and
subject to various spasmodic disorders. Some of
them presented involuntary twitching of the mus-
cles of the face, hesitation of the speech, &c. ; their
imagination was active, and their moral and physi-
cal sensibility very acute. They were very rest-
less and bore contradiction, or mental excitement,
badly.

" In dhildhood they presented local symptoms,
which indicated peculiar susceptibility of the
urinary organs, every impression of fear or anxiety
showing itself in this direction. What would have
produced shuddering or palpitation in other chil-
dren, in them caused a secretion of clear watery
urine, which they were obliged to discharge fre-
quently ; a sense of constriction of the hypogas-
trium, and a sense of titillation generally accom-
panied its discharge. This condition of the urinary
organs, continued more or less severe in all the

EXCESSIVE SEMINAL LOSSES. 263

cases until after puberty, when vit became joined
with other symptoms. One of these patients one
day experienced at the age of sixteen a fit of irrita-
bility and impatience, which, however, he succeed-
ed in repressing ; and he then felt sudden and
impetuous desire of micturition : whilst emptying
his bladder he perceived a large quantity of pure
semen discharged with the last drops of urine. This
occurrence was the forerunner of nocturnal and
diurnal pollutions, which at the age of twenty-
seven, had entirely ruined his health. Another, at
the moment of competition for a college prize, was
unable to find an expression he wanted : at the same
time he felt a want to make water, which he re-
sisted by firmly crossing his legs ; but his impa-
tience increased and he shortly experienced an
abundant emission without either erection or plea-
sure. A third patient suffered in the same way
under similar circumstances; he saw the moment
approach for sending in his thesis, the more he en-
deavored to hurry the less freely his expressions
flowed ; at length, on hearing the clock strike, he
suffered from so great mental disorder that he nearly
fainted ; at this moment emission took place. A
fourth having mounted on a high gutter of a house
to take some sparrows' nests, looked down into the
court below, and was suddenly seized with such
terror that he fainted ; on recovering and escaping
from his dangerous situation he found that he had
had an abundant seminal emission. The same cir-
cumstance occurred to a fifth, who, in descending a
ladder missed his footing and fell. Another patient
told me that if he looked down from a height, or
only fancied himself on the brink of a precipice, he
felt a sense of contraction in the genital organs,

264 EXCESSIVE SEMINAL LOSSES.

which passed rapidly to the base of the penis, and
ended by causing emission. The motion of a swing
produced the same effects in a seventh.

" Almost all these excitable persons were exposed
to erection, and even to pollutions whenever they
rode on horseback.

" Although all these involuntary discharges were
caused by extraordinary circumstances, I should
not have paid much attention to them if they had
not been followed by nocturnal and diurnal pollu-
tions, which the most trifling circumstance rendered
very serious. The disease, however, did not always
put on a serious aspect immediately after these sin-
gular accidents ; very often, indeed, it only injured
the patient's health long afterwards ; but as its
gravity could not be explained by any occasional
cause, I feel myself compelled to admit the exis-
tence of a congenital increased nervous suscepti-
bility of the genito-urinary organs. Every thing
indicates, in fact, that the organs of these patients
were rather excitable than weak and relaxed ; and
fhis condition was congenital because manifested
from the earliest infancy. This excessive sensi-
bility of the genital organs is, however, not always
preceded by a similar condition of the urinary ap-
paratus.

" In all these cases, tonics and excitants always
produced bad effects ; proving that the genital
organs were not suffering from atony or weakness."

SYMPTOMS BY WHICH THE SPERMATORRHOEA MAY BE
DETECTED.

In addition to the effects already enumerated,
there are several other symptoms of Spermatorrhoea

EXCESSIVE SEMINAL LOSSES. 265

that are very useful to note, for the use both of the
physician and patient. Some of them are such as
are observed in various diseases, but others are pe-
culiar to this affection, and enable us to ascertain
its existence when positive evidence is not to be ob-
tained.

Many persons suppose that in all cases the in-
voluntary discharge of semen is indicative of dis-
ease, and it alarms them very much. In many
cases, however, the emissions occur in those that
are continent, from excess of semen, and may then
be beneficial rather than hurtful. This is often the
case when they are in great quantity, though this
peculiarity is apt to alarm, from the idea that the
injury is proportionate to the quantity lost. Mr.
Lallemand remarks that :

" The most abundant nocturnal pollutions are far
from being always the most hurtful. When they
arise from true spermatic plethora, they often re-
lieve erotic excitement, with its accompanying agi-
tation, anxiety, uneasiness, and indefinable trouble
in all the functions. They are followed by a gene-
ral feeling of comfort ; the head becomes clearer,
the ideas more rapid, and the motions more nimble ;
there is more inclination to amusement, and to
every kind of occupation. I admit that nocturnal
pollutions do not often produce such good effects,
but then they are not often the result of spermatic
plethora ; they may too, easily lose their character,
so that habit alone tends to make them more and
more frequent. In the greater number of cases,
however, these evacuations are of very little im-
portance.

" But this state of excitement is too violent to
23

266 EXCESSIVE SEMINAL LOSSES.

last long : by degrees the organs become fatigued.
Deprived of their natural functions, and con-
sequently, being unstrengthened by regular exer-
cise, they may at last fall into a state of atony, or
the seminal vesicles may preserve the habit of con-
tracting, under the influence of slight or indirect
excitement. The evacuations now produce effects
quite opposite to those experienced in the beginning.
There are on waking, feelings of discontent, idle-
ness, weight in the head, disorder in the ideas, &c,
but this condition passes off in the course of the day,
and the patient is quite well on the following morn-
ing, if no further emission take place. After a
time, these effects become more serious and lasting,
and two or three days are required to remove them
completely. There is, however, no disease as yet,
because the economy is not as yet permanently dis-
ordered, but there is a degree of instability in the
patient's health, a valetudinary condition, the pro-
gress of which it is necessary to arrest."

Lascivious dreams are usually considered only as
causes of nocturnal emissions, but they are in fact
produced, in most instances, by the excitement ex-
isting primarily in the Genital Organs, and are
therefore symptoms of excessive vigor, in the first
stages, rather than of weakness, or disease. So
long as they only present pleasant images, without
any disagreeable sensations, and are not followed by
lassitude and weakness in the morning, they are not
indicative of anything serious. But when these
dreams are filled with filthy and disgusting ideas,
horrible sensations, and night-mare, during which
the discharge occurs without any pleasurable feel-
ing, and is followed by distress next morning, they

EXCESSIVE SEMINAL LOSSES. 267

are sure signs of disease. As a general rule the
danger commences when the pleasurable accompa-
niments of the dream begin to fall, and when the
discharge occurs without any sensations at all, or
with disagreeable ones, it is truly a bad symptom.

Diurnal, or daily, losses of semen are in general
worse symptoms than nightly ones, and they are
especially bad if they occur spontaneously or from
mere exercise. When they occur during the
movement of the bowels, or while urinating, though
they are usually indicative of a diseased state of
the parts, yet they may be made much worse by
constipation, gravel, and other affections of the
neighboring organs, a fact that should be borne in
mind when estimating their value. From not
having these circumstances explained to them
many persons lose semen in this way, perhaps for
years, without knowing anything about it. When,
their attention is directed to the occurrence, how-
ever, it will generally be easy for them to detect the
escape, whether it occur with the urine or after de-
fecation. When with the urine there is a sensation
as if something heavier than usual is passing, which
creates a slight pricking or tingling sensation, and
the urine looks thick and clou&y, with globules
floating in it like half-dissolved gum-arabic. If the
escape occurs during the movement of the bowels a
similar sensation is felt, and the end of the penis
will be found covered with a glutinous fluid, which
sometimes drops, but rarely runs away. More fre-
quently the flow does not take place till the move-
ment of the bowels is over, and perhaps not till the
patient is dressing himself; it then comes suddenly,
the whole quantity being discharged at once. This
is preceded by a kind of shock, felt in the perineum

268 EXCESSIVE SEMINAL LOSSES.

and neck of the bladder, and sometimes with slight
erections, accompanied by pleasure. In some cases
a discharge occurs in this way of simple mucus,
mixed with the fluids of the Prostate and Vesicles,
and this should be suspected when losses of this
kind are complained of, till a proper examination
is made. These mucous discharges, however,
never consist of more than a single drop, or two
at most, and are quite thin and transparent, while the
seminal emission is both thicker and more opaque,
and in greater quantity. If the patient empties
his bladder before going to stool the appearance will
be more obvious, and if he observes a thick gummy
discharge, during or after the passage of the bowels,
there can be no mistake as to its being real semen.
It is more difficult to ascertain the presence of the
semen when it escapes in the urine, because it is so
diluted, and undergoes several changes, I shall there-
fore be particular to give all the indications that can
be relied upon in such cases. — In the first place it
must be recollected that the semen never escapes
during the first flow of the urine, but always with
the last few drops, or even after the bladder is fully
emptied. There is in general the peculiar sensation
already described, with slight pleasurable feeling,
and a few spasmodic jerks of the neck of the blad-
der, by which the expulsion of the last drops is ef-
fected.— This is quite sufficient to distinguish sper-
matorrhoea from gleet, or a discharge from urethral
inflammation, as in such cases the mucus always
escapes with the first flow of urine, and is not ac-
companied by any of the sensations above described.
The appearance of the urine also, if carefully noted,
will nearly always be sufficient to indicate the na-
ture of the affection. The presence of the semen

EXCESSIVE SEMINAL LOSSES. 269

is nearly always indicated by the gum-like globules
mentioned above, and also by numerous little irre-
gularly-formed granules, somewhat like bran, which
settle to the bottom of the vessel. These granules
are soft, and fall down to the bottom of the vessel
before the urine cools, without ever adhering to the
sides, which distinguishes them from gravel. In
short no other discharge furnishes anything like these
granules, so that their presence is a sure proof of
involuntary emission.

Sometimes patients have peculiar sensations in
other parts of the body whenever a pollution occurs,
thus some experience a pain in the nipple or back
of the neck, some a cold chill and shivering, while
others feel a burning heat round the anus, and after
these sensations they always observe the flocculent
deposit in the urine.

As the disease progresses the bran-like granules
become fewer in number, and smaller, and at last
almost totally disappear, so that the existence of the
spermatorrhoea has to be ascertained by other symp-
toms. The urine is still clouded with the gum-like
deposit, and there settles to the bottom a number
of little brilliant points, something similar to what
is seen in newly-boiled mush. Like the granules
they are soft, and do not adhere to the vessel. —
These different appearances result from the altered
condition of the semen, which, as the disease pro-
gresses gradually loses its usual character, and
eventually becomes totally changed.

I have known patients much engaged in study in
whom involuntary emissions occurred in a very sin-
gular manner. They would experience, while sit-
ting perfectly still, a sensation in the perineum or
at the root of the penis, as if the parts were sud-

23*

270 EXCESSIVE SEMINAL LOSSES.

denly drawn together and pinched. So distinct and
strong is this felt sometimes that the person imme-
diately starts and compresses the part in his hands.
The sensation lasts but a short time, however, and
nothing further takes place, if he remains still, but
immediately he begins to exercise, or the next time
he urinates, a quantity of semen escapes. This
shows that the emission really occurs when the sen-
sation is felt, but there is no action of the muscles
to expel it till the parts are in some way made to
act for other purposes.

IMPOTENCE FROM INVOLUNTARY EMISSION.

Whenever impotence is not obviously owing to
any of the causes enumerated in the previous part
of this work, it is nearly always the result of pol-
lution, and perhaps as a general rule it arises from
this cause oftener than from any other. There are
two modes in which it may be brought about by
this cause, first by the destruction of the powers of
the Genital Organs, from general weakness, and
secondly from a peculiar change which it leads to
in the semen. For erection to take place there is
always needed the presence of healthy semen in
the seminal vesicles, and if this does not exist of
course no erection can occur, and impotence neces-
sarily follows. Any cause, therefore, which impairs
the vitality and health of the semen must lead to
impotence, and no cause does so more surely than
long-conlinued involuntary emissions.

The mode in which involuntary emission, or
Spermatorrhoea, from any cause, affects the semen,
appears to be this. It has already been explained
how the Seminal Animalcules are produced from

EXCESSIVE SEMINAL LOSSES. 271

certain little grains or vesicles, found first in the
semen of the Testicles, which break open and allow
the Animalcules to escape.

Now these little beings are the most essential
parts of the seminal fluid, and without them it can
neither act properly on the male organs nor impreg-
nate the female ovum. If, therefore, their develop-
ment is prevented Impotence and Sterility must re-
sult, and this is what really follows from Sperma-
torrhoea. It is necessary for the semen to remain a
certain time in the Vas Deferens and Vesicles,
after it leaves the Testicles, so that the granules
may burst and the Zoospermes become perfect, and
if it be expelled from the body too soon this has not
time to occur. The precise time requisite for the
semen to remain in the body, after being formed by
the Testes, is not known, and it probably varies,
both with different individuals and also under differ-
ent circumstances in the same person. For a time
the organs can, if healthy, perfect the semen rapidly,
so that a man can expel it very frequently, and yet
have it healthy, but if this excess is continued too
long the power of the parts gradually weakens and
the semen is at length discharged imperfect. This
is precisely what follows eventually, both from
licentious excess and from involuntary emissions ;
the semen has not been allowed to remain in the
organs sufficiently long, and when it is expelled no
animalcules are found in it, but only the granules
from which they would have been developed had it
remained. These are what are seen in the urine,
in cases of long-continued involuntary emission, like
little shining points, and probably also the bran-like
grains, observed at an earlier period, are the gran-
ules in an undeveloped state. In many cases of

272 EXCESSIVE SEMINAL LOSSES.

long-continued Spermatorrhoea, both from excess
and involuntary, the change is still more decided,
so that the semen is merely like thin gum-water, and
utterly incapable either of stimulating erection or
of impregnating. — This is the true explanation why
those who are exhausted by excesses, and those who
have long sufFered from involuntary emissions, be-
come impotent and sterile, and it shows us what is
really needed to effect a cure. If we can arrest the
discharge, and restore a certain degree of tone and
vigor to the organs, the semen may be again re-
tained sufficiently long, and may become perfect, so
that the power of erection and impregnating may
be again enjoyed. The chances of this are les-
sened, however, in proportion to the time the flow has
continued, and at a certain stage all our efforts are
fruitless. I have, however, known some remarkable
instances of restoration, even under the most un-
promising circumstances. In one instance a man
aged forty-seven came to consult me, who had been
perfectly impotent for nine years, during which he
had not experienced the slightest manifestation of
sexual power, nor scarcely ever been free from a
discharge, which, however, was almost like water.
According to his own statement this unfortunate
condition was owing to former licentiousness, his
indulgence having been' excessive till the wretched
state of his general health, and finally his complete
loss of power, compelled him to abstain. I was
obliged to say to him that the chances of restoration
were so small as scarcely to be worth calculating
upon, and that I should not be justified in giving
him any hopes at all. He was so exceedingly anx-
ious, however, and pressed me so earnestly to take
him under my charge that I did so, though with

EXCESSIVE SEMINAL LOSSES. 273

considerable reluctance, and with great misgiving.
Fortunately he was a man of wealth, and leisure,
and disposed to follow out implicitly all the direc-
tions given him. — The particular plan of treatment
that was followed is not necessary to be described
here, as I shall speak upon it generally further on,
but the result is stated as an instance of what can
be sometimes accomplished even under very unpro-
mising circumstances. I had this patient under my
constant care for fifteen months, at the end of which
time his sexual powers were sufficiently restored to
allow of his marrying, which he did and became a
father. It took three months to stop the constant
emission, and after that six months more elapsed
before animalcules began to appear in the semen,
after which his improvement was very decided,
though in all probability his powers will never be
equal to what they were before, nor will they endure
so long as they otherwise would have done.

In cases where impotence is only partial or has
existed only for a short time, proper treatment can
nearly always effect a decided improvement. Every
moment, however, is precious in such cases, and no
man should feel indifferent even to a slight falling
off in his sexual vigor, if it continues, and if he de-
sires to preserve his powers. A short delay may
lose all chance of restoration ; and it should be re-
collected also that, in most instances, the derange-
ments which cause impotence have often serious
effects, and generally so impair the health as to en-
danger life.

I am almost daily seeing instances of weakened
power from Spermatorrhoea, and though I am com-
pelled to admit that in some of them relief is hope-
less, yet in many the result of the treatment is most

274 EXCESSIVE SEMINAL LOSSES.

satisfactory, and highly encouraging to those simi-
larly affected. There is occasionally one result of
Spermatorrhoea different from any of these above
described, and which is sometimes of considerable
importance, both socially and as a point in medical
jurisprudence. Some patients, of vigorous habits
of body will continue to secrete the semen, and
retain their powers of association, even after the
disease has existed for a considerable time. They
may, however, be sterile, though not altogether im-
potent, and the fault of barrenness is ascribed to the
female, because no defect exists, so far as can be
seen, in the husband. These men are able to asso-
ciate, as before remarked, and to emit semen, but
on examining that fluid none of the animalcules are
formed perfect, being either all dead or half formed.
The semen in short is perfect enough to stimulate
the male organs, to a certain extent, but not perfect
enough to impregnate the female ovum, and I have
no doubt but that many cases of supposed barren-
ness in females are owing merely to a defect of this
kind in their husbands. I have known men affected
in this way who were remarkably active and vigor-
ous, and in whom no imperfection whatever could
be suspected till pointed out by the microscope. — M.
Lallemand was the first author who alluded to this
important subject, and his remarks are well worth
reading : —

" Infecundity. — Impotence is an absolute cause of
infecundity because it prevents the conditions neces-
sary to fecundation from taking place ; but although
the act of coitus may be accomplished, it does not
follow that the person should always be able to per-
petuate his species. Stricture of the urethra may

EXCESSIVE SEMINAL LOSSES. 275

prove an obstacle to the discharge of seminal fluid ;
or the fluid may be directed towards the bladder or
the parietes of the urethra, by deviation of the ori-
fices of the ejaculatory ducts. The secretion may
be altered in its nature, it may only contain imper-
fect spermatozoa, &c. A man may, therefore, be
unfruitful witout being impotent. On the other
hand, I have met with many patients suffering from
diurnal pollutions who had children exactly resem-
bling them, even during the duration of their dis-
ease. Indeed, I have seen several cases in which
the disposition to involuntary discharges was here-
ditary, and they affected both father and son. The
disease is, however, essentially irregular in its pro-
gress ; it may continue long without doing serious
injury to the health, long remissions may be expe-
rienced, or even a perfect cessation of the complaint
for a longer or shorter time ; we may easily con-
ceive, therefore, that in the first degree, or during
one of the periods of remission, fecundation may
take place. When the disease is further advanced,
however, many causes concur to render coitus un-
fruitful. Ejaculation is weak and precipitate, so
that the seminal fluid cannot be thrown into the
cavity of the uterus ; it is not sufficient in order to
fecundate, simply to spread the fluid over the va-
gina; it must be projected with sufficient force to
pass through the orifice of the uterine neck. Be-
sides, in these cases the erections, even when they
permit sexual intercourse, are incomplete and of
very short duration, emission takes place without
energy and very soon ; so that during such rapid
acts the uterus and Fallopian tubes have not suffi-
cient time to experience, the excitement necessary to
carry the semen to its destination, even when it

276 EXCESSIVE SEMINAL LOSSES.

passes the neck of the uterus. The semen itself
also undergoes great changes, to which perhaps
the loss of the fecundating power is chiefly
attributable. Microscopic researches have elu-
cidated this formerly obscure subject ; I have
discovered, for instance, that the spermatozoa
undergo changes similar to those of the fluid
which serves as their vehicle ; these changes
are exceedingly important, and are owing to
defective formation. Spermatozoa may be met
with in a less thick and less opaque fluid than natu-
ral, for they are not produced by the same parts, or
in the same manner ; but when the secretion is per-
fectly thin and watery, the functions are so seriously
affected that the animalcules are altered ; they are
less developed, less opaque, and less active than na-
tural ; indeed, they are so transparent that peculiar
precautions are necessary in order to make sure of
seeing them ; their motions are weak, slow, and cease
very soon ; and they rapidly undergo decomposition.
All these characteristics show how much their texture
is relaxed, and how imperfectly they are organized.
" It is evident that the least arrest of development
in the spermatozoa must prove an insurmountable
obstacle to fecundation, even if the only function of
the animalcules be to carry the liquor seminis to the
ovum. When, however, their imperfect development
only arises from a too rapid formation it may soon
be obviated. It suffices that the involuntary dis-
charges should cease for a few days only, in conse-
quence of some accidental cause, or of one of the
spontaneous changes of this extraordinary disease,
in order for the desires to become more lively, the
erections more energetic and prolonged, and for the
function to be accomplished in a natural manner.

EXCESSIVE SEMINAL LOSSES. 277

Fecundation is, therefore, possible, as I have pre-
viously stated, during the whole duration of one of
these intermissions.

" This is not the case when the spermatozoa are
malformed, rudimentary, more or less deprived of
tail, &c, for these changes only take place when
there is a serious alteration in the structure of the
testicles. I have taken every opportunity of dis-
secting the testicles altered in these cases, and I
have always found the secreting structures paler,
drier, and denser than natural, and the cellular tis-
sue more resisting, and with difficulty allowing the
secreting ducts to be separated one from another.
Sometimes half or two-thirds of the testicle were
transformed into a fibrous or fibro-cartilagmous tis-
sue mixed in a few cases with tuberculous matter.
It is the same also in the epididymis, where I have
even seen traces of ossific deposit in the midst of
cartilaginous indurations. These changes, caused
by previous inflammation, perfectly explain why
the development of the spermatozoa can no longer
proceed normally.

" Although in such cases the secretion of semen
may be more or less diminished, pollutions may still
be present if the seminal vesicles have shared the
inflammation by which the testicles have been af-
fected, as happens in most cases of orchitis arising
from blennorrhagia. I have at present a patient
who presents a remarkable example of both these
effects arising from this cause : he is now forty-one
years of age, and had blennorrhagia followed by
inflammation of both testicles at twenty-five. Soon
after his recovery, he married but has never had
children, although the act has been performed regu-
larly if not frequently. He became subject to noc-

24

278 EXCESSIVE SEMINAL LOSSES.

turnal, and sometimes diurnal pollutions, which in-
creased by degrees. His health became disordered,
but coitus was still possible. The semen passed, al-
though it presented its characteristic odor but never
showed under the microscope other than very small
and brilliant globules, without any appearance of
tail, but easily distinguishable from globules of mu-
cus, the dimensions of which are five or six times
larger. The epididymis of both sides is volumi-
nous and irregular. One testicle is adherent to the
skin of the scrotum, and the other appears smaller
than natural.

" Malformation of the spermatozoa, therefore,
arises from deep-seated changes in the tissues of the
testicles, changes which do not permit the animal-
cules to assume their normal form, and, therefore,
render infecundity permanent.

" To sum up then. Involuntary seminal dis-
charges may oppose fecundation previously to ac-
tually producing impotence, by diminishing the
energy of all the phenomena that concur to the ac-
complishment of the act, and by preventing the
complete development of the spermatozoa^ as well
as the elaboration of the fluid which acts ,as the
vehicle for them.

" These conditions may be rapidly altered by the
simple diminution of the involuntary discharges,
and fecundation may again become possible.

" This cannot be the case when infecundity de-
pends on malformation of the spermatozoa — such
malformation arising from permanent alteration in
the organs that supply them.;'

Microscopic Examination of the Semen. — This ia
a subject of great interest to every one, and of im-

EXCESSIVE SEMINAL LOSSES. 279

mense importance to the pbysican and patient. The
proper mode of pursuing such examinations has been
so well explained by M. Lallemand that I cannot
do better than copy his remarks, to which I will add
here that with good instruments there is no difficulty
whatever in the process.

"Microscopic Examination. — Since the discovery
of the spermatozoa, their presence in the seminal fluid
has attracted the attention of all who have sought
means of distinguishing it from other fluids. Mi-
croscopic examination of the spermatozoa, however,
not only requires an excellent instrument, but cer-
tain precautions which may be dispensed with in the
investigation of coarser objects. As the spermatic
animalcules can be only seen by means of trans-
mitted light, it is necessary that the glass on which
the fluid to be examined is placed should be of uni-
form thickness, and without bubbles or striae. The
fluid to be examined should be covered by another
layer of extremely thin glass made on purpose, and
not by portions of mica, which are seldom free from
cracks, and never perfectly transparent. This thin
layer of glass is indispensable in order as much as
possible to diminish the thickness of the fluid, to
render it perfectly uniform, to hinder evaporation
and prevent the object glass from being soiled by it.
A single drop of fluid suffices for a complete ob-
servation, a larger quantity always proving incon-
venient. The little glass that covers the liquid must
be firmly pressed down so as to spread .it out, arrest
the currents that take place in it, and drive out the
air bubbles. Although the glasses should seem to
touch each other the spermatozoa move with perfect
freedom in the space between them, so long as they

280 EXCESSIVE SEMINAL LOSSES.

preserve their energy and evaporation has not pro-
ceeded too far : should such be the case, however,
a drop of tepid water favors and much prolongs
their motions. However thin the layer of fluid may
be, it is impossible to comprehend its whole thick-
ness at once with a very high power, and it is, there-
fore, necessary to alter the focus frequently in order
to be sure that nothing escapes observation. And
this is especially important in examining a drop of
fluid obtained from diurnal pollutions, because there
are frequently only two or three spermatozoa con-
tained in it. It is also necessary to change the po-
sition of the reflector frequently, in order to vary
the direction and intensity of the light. The sper-
matozoa are often exceedingly transparent in cases
of disease, and a very bright perpendicular light is
by no means the best for showing them. "Varying
the density of the fluid under examination, either
by adding water or by permitting evaporation, is
also often useful. The semen contains matters fur-
nished by the seminal vesicles, the prostate and the
urethra, and when the fluid is too thick these matters
hide the animalcules. A drop of water applied to
the edge of the covering-glass penetrates underneath
it, and the spermatozoa are more isolated, at the
same time that their contour is rendered more de-
fined by the diminution in density of the fluid. On
the other hand the refractive power of the sperma-
tozoa differs little from that of the fluid in which
they are contained, and their thinnest portions are
traversed by the light without affording any distinct
images to the eye. In this case there are only seen
very small ovoid brilliant globules terminated by a
little point. As soon as the water begins to pene-
trate between the glasses, the rapid motion set up

EXCESSIVE SEMINAL LOSSES. 281

prevents the objects from being clearly distinguished ;
but as soon as rest has been re-established the tails
of the animalcules appear, and their dimensions seem
to have increased in consequence of the diminished
density of the surrounding fluid : water suffices to
produce this result. It is more sensible, however,
when a small quantity of alcohol is added : but the
forms of the animalcules are, after a time, altered
by this agent ; and it is, therefore, advisable to use
water only when it is intended to keep the prepa-
ration.

"Evaporation sometimes produces not less re-
markable changes in the seminal fluid. I have
frequently in cases of spermatorrhoea failed to
perceive any thing in the fluid under examination
for half an hour, an hour or more ; then suddenly
an animalcule has made its appearance ; then a
dozen, and. then perhaps a hundred in the space of
a few minutes. The following morning, when de-
siccation has become complete, there are no longer
any traces of these animalcules, or, at all events, I
have been only able to distinguish their tails, the
other parts of them being fixed in the dried up
mucus. The absorption of a drop of water has
restored the phenomena observed the night before.

" These phenomena are easily explained ; when
the refractive power of the spermatozoa is the same
as that of the circumambient liquid, the light tra-
verses the whole in the same manner, and the mass
appears homogeneous. But evaporation acts more
rapidly on the liquid than on the organized bodies
contained in it ; and when the difference of density
alters the refractive power the forms of the sperma-
tozoa are momentarily defined because they have
become more transparent than the remainder of the

24*

282 EXCESSIVE SEMINAL LOSSES.

fluid. When desiccation is complete, however, the
animalcules again disappear, because the refractive
powers of mucus and dried animalcules are again
equal. The absorption of a small quantity of
water re-produces the same phenomena, which may
be repeated almost indefinitely, since the matter
confined between the two layers of glass undergoes
no other appreciable alteration.

" In order to be enabled to discover spermatozoa
quickly in cases of disease, it is necessary that
they should be well studied in healthy cases. This
may be accomplished in the following manner : —
After coitus there always remains a sufficient
quantity of seminal fluid in the urethra to serve for
precise and complete microscopical examination.
This may be obtained by pressing the canal shortly
after the act, and receiving the drop of fluid from
the orifice of the glans on a plate of glass. In this
drop of fluid thousands of amimalcules may be
seen, agitating themselves like so many tadpoles in
a pool of stagnant water, only that the tails of the
spermatozoa are relatively longer and thinner, and
that the head presents a brilliant point near its in-
sertion. Generally the number of these amimalcu-
les prevents them from being easily examined, and
it becomes necessary to spread them out by intro-
ducing a small quantity of water, and pressing
firmly down the thin glass that covers them ; they
are found most separated on the edges of the fluid.
If the water added be of the temperature of the
body their motions become free and lively, and con-
tinue so until cooling and evaporation affect them.
By avoiding these two causes of disturbance the
motions of the spermatozoa may be kept up during
several hours.

EXCESSIVE SEMINAL LOSSES. 283

" However long a time may have elapsed after
coitus there are always spermatozoa in the urethra,
provided they have not been washed away by the
passage of urine. Although the point of the glans
may be quite dry, and pressure along the whole
length of the canal may not produce the least
dampness, still on passing urine living animalcules
may be obtained from the first drop which escapes.
This may be received on the glass, and is perhaps
the easiest and most natural mode of obtaining
spermatozoa for microscopic examination.

" It is evident that the same experiments may be
applied in the case of nocturnal pollutions as well
as in all other seminal discharges in whatever man-
ner they may occur. But many errors may arise
from commencing with cases of disease, for it is
during perfect health that the spermatozoa are most
active, and their development most complete, and
they live longer after coitus than after any other
kind of seminal discharge.

" Having thus described the means by which my
microscopic observations may be verified, I proceed
to show their results.

" Spermatozoa. — Out of thirty-three bodies which
I have examined for spermatozoa, I only twice found
these animalcules in the testicles. In one of these
cases the patient died from the effects of a fall on
the day following it ; in the other acute gastroen-
teritis was the cause of death. The seminal fluid
was most abundant, and contained the greatest
number of animalcules in the former case. The
other patients died of chronic diseases after pro-
tracted sufferings. One only among them died on
the second day of acute peritonitis, but he was
seventy-three years of age. In thirty-one of these

284 EXCESSIVE SEMINAL LOSSES.

patients the testicles were soft, pale, and as though
withered. On section they presented a grayish as-
pect, and did not furnish any liquid ; the structure
was almost dry, and contained a few blood-vessels ;
the secreting canals were easily seperated from one
another and could be spread out under the micro-
scope without breaking. They presented very bril-
liant granules, all of exactly the same appearance,
about the size of the head of a spermatozoon, ten
times smaller than corpuscles of blood or mucus,
and differing from the latter by the constancy and
regularity of their form. These brilliant bodies,
which occupied the place of the spermatozoa, are
worthy of notice, because they offer considerable
analog}'- to the appearances presented by the semen
under certain circumstances.

" In order to observe what is present in the se-
creting canals of the testicle it is necessary to
spread out a portion of one of them under the mi-
croscope, after having examined it dry to allow a
drop of water to penetrate between the two glasses,
and to follow the changes which take place ; then
to press down the glass so as to flatten the parietes
of the canal, rupture it, and press out a portion of
its contents ; lastly, these must be examined again
when desiccation is complete, for the spermatozoa
found in the canals are then best seen.

" In the epididymis I have never found sperma-
tozoa, except in the two cases in which they were
also found in the testicles. In all the others I met
with these animalcules only in the vas deferens or
seminal vesicles. There were no animalcules at all
to be found in the patient who died at the age of
seventy-three. It has always seemed to me that
the animalcules were less numerous in proportion as

EXCESSIVE SEMINAL LOSSES. 285

the patients had suffered long ; and in extreme cases
I have generally found them only in the seminal
vesicles. The fewer the spermatozoa the more dif-
ficult were they of detection on account of their
extreme transparency. In some case's I have only
suddenly discovered them after examining for an
hour or two, the liquid having previously appeared
quite homogeneous. The dimensions were the
same as those of the best developed animalcules,
but they were pale throughout their whole extent,
and more transparent than the surrounding fluid.
Complete desiccation often caused them to disappear
altogether ; but the same phenomena could be re-
produced by the absorption of a small quantity of
water.

" In cases of phthisis, caries of the vertebrae,
white swelling, &c, I have had great difficulty in
distinguishing the animalcules, probably because
these diseases do not cause death for a long time.

"I have almost always found in the seminal ve-
sicles, especially at the bottom of any depression, a
thick, grumous brilliant matter, varying in its aspect
and color, but considerably resembling thick paste,
and more or less transparent ; with a high power
the granules of this matter appear large, irregular,
more or less opaque, and without any constant
shape. They are evidently the products of the in-
ternal membrane of the vesicles, for they are found
with similar characters in the accessory vesicles
of the hedgehog, rat, &c, which never contain
seminal animalcules, and do not communicate
directly with the vasa deferentia, which, again, never
contain any similar substance. This matter is,
therefore, analogous to that secreted by the prostatic
follicles, Cowper's glands, &c. Its functions are

286 EXCESSIVE SEMINAL LOSSES.

the same, and for many reasons it merits special at-
tention.

" The secretion of semen diminishes in all seri-
ous diseases; and seminal evacuations become very-
rare, especially towards the last. It is not, there-
fore, astonishing that the products of the mucous
membrane predominate in such patients over those
of the testicles, and that such mucus should become
more consistent during its long residence in the de-
pressions of the vesicles. Hence, the difference
observable between the semen obtained from the
vesicles after death, and that which is passed by a
healthy person. Nevertheless, after long-continued
continence more or less large granules are often
seen in the semen of a healthy person, and these
are perfectly distinct from the fluid part. When
the emissions are more frequent granules of the
same kind may be observed, but much smaller.
These facts are important when applied to explain
several symptoms of diurnal pollutions.

" I have already stated that on causing the pa-
tients to make water in a bath, the semen passed
may be easily recognised by means of its globules
which whirl about in the middle of the cloud
formed towards the close of micturition. From
what we have just seen it is evident, that these
globules come from the internal membrane of the
seminal vesicles. They may be wanting in very
severe cases where the semen has no time to acquire
consistence ; but their presence leaves no doubt as
to the existence of diurnal pollutions, because they
can only be furnished by the seminal vesicles. On
the other hand, I have invariably found spermatozoa
in the urine of patients who observed this phenome-
non in the bath. The same remarks hold good

EXCESSIVE SEMINAL LOSSES. 287

when applied to the globules which the urine depo-
sits in certain cases of diurnal pollutions, and which
have been compared by some to grains of bran, by
others to millet seed, pearl barley, &c, according
to their size. These globules are perceived as soon
as the urine is passed, they are roundish, very soft,
and do not give any sensation when squeezed be-
tween the finger and thumb ; they cannot, therefore,
be confounded with urinary salts which are depo-
sited only when the urine has cooled, have a crys-
talline form, and give the sensation of a hard body
to the finger. The vesical mucus also is only depo-
sited on cooling, and does not furnish brilliant
granules. As to pus, its appearance is easily de-
termined. I have found animalcules whenever
these globules appeared in the urine ; and hence it
is that I have pointed them out as certain signs of
diurnal pollutions.

" I have also noticed that in some cases the urine,
when held against the light, presents in the middle
of a flocculent cloud multitudes of quite charac-
teristic brilliant points. These are smaller, and,
consequently, lighter globules than those which in
other patients fall to the bottom of the vessel. They
are neither observed in the mucus of the bladder
nor in the prostatic fluid, which alone present clouds
analogous to those of diurnal pollutions. Such
brilliant points also arise from the seminal vesicles,
and their presence is, therefore, an indication that
the urine contains semen. This I have often veri-
fied with the microscope. I should, however, warn
those who wish to repeat my experiments, that it is
not in the midst of the flocculent cloud that the
zoosperms are to be sought, but at the bottom of the
vessel, to which they soon fall on account of their

288 EXCESSIVE SEMINAL LOSSES.

greater specific gravity. The results of all my ob-
servations on the dead subjects, therefore, convince
me of the influence of serious and long-continued
diseases on the functions of the spermatic organs.
But it is not only in the morbid state that these ex-
perience great variations ;. remarkable differences
may exist between healthy individuals not only in
the quanity of semen secreted in a given time, but
also in the number, appearance and dimensions of
the spermatozoa. In this respect I have observed
differences amounting to a third, and, in some cases,
to half. The comparison is very easily established.
When the semen is kept under a thin glass as I
have before described, it is not in danger of under-
going any changes, and may be always, by the ad-
dition of a drop of water, compared with a recent
specimen.

" Notwithstanding the facility with which noc-
turnal pollutions may be recognised, I have sub-
mitted the semen collected after them, by individuals
in various conditions of health, to microscopic
examination. At first when the evacuations are
still rare and the semen preserves its ordinary
characteristics, the animalcules do not present any
remarkable circumstances in regard to their num-
ber, dimensions, &c. ; but when the disease has
reached a sufficient degree of gravity to affect the
rest of the system the semen becomes more liquid,
and the spermatic animalcules less developed and
less lively. Their number, however, does not as
yet sensibly diminish ; indeed, in some cases, it
seems increased. As the disorder advances the
erections diminish, the semen becomes more watery,
and the animalcules are often a fourth or a third less
than natural, and the tail is often distinguished

EXCESSIVE SEMINAL LOSSES. 289

with difficulty tinder a power of three hundred
diameters. At a still later period the animalcules
become fewer, and in two individuals in the last
stage of the affection the semen no longer contained
animalcules, although it retained its characteristic
smell. Examined with high powers and every pro-
per precaution, I only found, in this semen, brilliant
globules, all exactly alike, and about the same size
as the head of a spermatozoon.

" The microscopic examination which I have
made of semen passed during efforts at stool give
analogous results. When such discharges only
take place accidentally and at long intervals, the
semen is thick, whitish, impregnated with a power-
ful smell, and abundantly furnished with well-de-
veloped animalcules. I have sometimes even found
a few alive after an hour or two. But when these
discharges become so frequent or habitual as to
constitute disease, they become less abundant and
the semen losses its normal properties. The sper-
matozoa are generally smaller than in the healthy
condition, and always less lively. I have some
preparations in which they are only of half the
ordinary size, and I have never been able to find a
single living animalcule a few minutes after the
fluid had been expelled. When the disease has be-
come much aggravated the spermatozoa become
rare, and they are sometimes replaced by ovoid or
spherical globules similar to those of which I have
already spoken. In three patients in an extreme state
of disease I found nothing else, although they passed?
as much as a dessert spoonful of semen at each,
stool. Such cases, however, are exceedingly
rare.

" In diurnal pollutions happening during the pas-
25

290 EXCESSIVE SEMINAL LOSSES.

sage of urine the following means may be employed
to show the presence of spermatozoa.

" The urine should first be filtered in a conical
filter, when on account of their weight, the greater
number of the spermatozoa will remain on the lowest
part of the paper. By taking this portion and
turning it upside down in a watch-glass containing a
few drops of water the animalcules become detached
from the paper by degrees, and fall to the bottom of
the fluid in the glass. After twenty-four hours
maceration in this position, the paper may be taken
away and the spermatozoa may be readily obtained
by using a drop from the bottom of the fluid in the
watch-glass for examination. This mode of pro-
ceeding is a sure one, but it requires considerable
time and trouble for its performance. I have
already stated that the urine does not always contain
spermatozoa in cases of diurnal pollutions ; there-
fore, the urine of the same individual would perhaps
require examination on many occasions before the
certainty of their presence could be established, and
few medical men in active practice have time to
devote to such experiments. I for one should have
long since given up treating these patients had I
been obliged to repeat in every case such long and
tiresome examinations. Ten days or a fortnight are
sometimes passed without the appearance of sperma-
tozoa in the urine, and hence all who are accusr
tomed to microscopic researches will admit the
indefinite amount of trouble and time required.

il Fortunately, however, there is a more simple
method by which such examinations may be con-
ducted. It will be recollected that the semen
always escapes either with the last drops of urine,
or immediately, or soon afterwards. By directing

EXCESSIVE SEMINAL LOSSES. 291

the patient, therefore, to compress the urethra im-
mediately after micturating, and to receive the drop
of fluid pressed out on a piece, of glass, sufficient
animalcules will be obtained from the walls of the
urethra for microscopic observation. These being
covered with a thin lamella of glass may be either
at once placed under the microscope, or may be al-
lowed to dry, and examined at a future time, a drop
of water being previously added. This mode of
examination is, therefore, easy for all practitioners
who possess a good microscope, after they have ac-
customed themselves to the inspection of the sperma-
tozoa in their natural state. The changes which I
have mentioned as occurring in the semen must be
borne in mind, however, and the animalcules must
not be expected to appear either so large, so well
defined, or so numerous as in cases where there is
no disease."

TREATMENT OF SPERMATORRHOEA.

In treating Spermatorrhoea there are two things
necessary to be ascertained, first the primary ex-
citing cause, and secondly the existing cause, if
such there be, that keeps up the disease. Most
usually we discover that masturbation has been in-
dulged or that the patient has been addicted to ex-
cess, and it is of course necessary that such evil
practices be immediately and totally abandoned, be-
fore ahy improvement can be hoped for. Next we
must see if there be any skin disease, piles, consti-
pation, worms, gravel or any other cause that may
keep up the irritation, and when this has been re-
moved the actual treatment of the parts themselves
may begin. This treatment must consist in the

292 EXCESSIVE SEMINAL LOSSES.

application of those means best calculated to remove
the irritability or relaxation existing in the ducts and
seminal vesicles, and to give tone to the Testes. So
long as the ducts and vesicles retain their irritability
or remain open the semen must necessarily escape,
and it becomes therefore absolutely requisite to re-
move such disability, and restore to them that power
of contraction which they possess in a healthy state.
In some recent cases very simple treatment will
suffice. If the patient leaves off all bad habits,
avoids constipation, attends carefully to his diet, takes
no simulants either in food or drink, and carefully
bathes himself in cold water round the parts, night
and morning, a decided improvement will often be
experienced. He must, however, avoid all excite-
citement of the mind or feelings, never over-fatigue
himself, and not lie in bed after he is awake in the
morning. — These directions are more especially
applicable to those incipient cases common among
young men, when the emission takes place at night,
usually in consequence of a dream. It will usually
be found in such cases that the loss occurs towards
morning, and most frequently when the patient is
half asleep and half awake, a state which is very
apt to produce sexual excitement. Many young
men have told me that they never had an involun-
tary erection except at such times, and that if they
ever remained in that half dreamy condition it was
nearly certain to occur. However disagreeable it
may be, therefore, the patient must rise immediately
he is awake, unless it be too early, and he feels con-
fident he can go sound to sleep again. Many per-
sons whenever they awake and feel any tendency
to erection, always rise and bathe themselves and
then lie down again, and by these means escape the

EXCESSIVE SEMINAL LOSSES. 293

emission. It is particularly important also that late
suppers should be avoided, and that no coffee should
be drunk, and no tobacco used. This is very neces-
sary, for many of my patients assure me that a sin-
gle cigar towards bed-time will ensure an emission,
in spite of all the precautions they can take.

If all young men were to observe these precau-
tions habitually they would seldom be troubled
with involuntary emissions at all, because the parts
would be so strengthened, and all irritation so
promptly subdued, that it would scacely ever arise,
unless from excessive abuse or masturbation. The
remarks which I formerly made as to the import-
ance of regular occupation, both for body and mind,
are also particularly applicable here, there being
no doubt but that idleness very much predisposes
to all these evils.

Internal medication is seldom of much benefit,
but unfortunately most persons think the contrary,
and this great and fatal error is often the means
of perpetuating the disease. Men think, when they
are afflicted with involuntary emission, that it is
only necessary to take certain drugs to be made well
again. They accordingly either allow the evil to
go on till it becomes incurable before they do any-
thing at all, or else they rely upon the medicine
alone and neglect all other means. The conse-
quence is that they obtain no relief from what they
have taken, and find that the time has been uselessly
lost during which a cure was possible. I do not
hesitate to say that any man, by observing the sim-
ple advice already given, will be more benefitted
without any medical treatment whatever, than he
can be by the best he can receive if that advice be
neglected. It is true that a little medication is oc-

25*

294 EXCESSIVE SEMINAL LOSSES.

casionally beneficial, but it is not of a specific cha-
racter, or adapted to all alike, but must be varied
according to circumstances, and in all cases it should
be regarded merely as assisting, and not as being
capable of curing alone. It is more especially
when there is gravel or considerable irritation of the
urethra and bladder, that good can be done by medi-
cation, and even then it is of a simple character.
If there is any heat and burning when the urine is
discharged, with a discharge of thin mucus at the
beginning of the flow, the following pills will be
beneficial.

R. Balsam of Copaiva, two drachms ; Magnesia,
seven grains. To be made into pills of four grains
each, of which two may be taken three or four times
a day.

If the urine is high colored, and deposits a red
sediment upon the sides of the vessel, indicating
gravel, the following powders will be better.

R. Dried Bearherry leaves, (Uvce Ursi) one
drachm and a half; Bicarbonate of Soda, one
drachm. Mix them and divide into twelve powders,
of which one may be taken three times a day in
water.

These powders are also excellent when there is
simply irritation of the bladder, causing a frequent
desire to urinate. For this particular trouble it is
also advisable to drink but little, and never to use
hot fluids of any kind, nor spices, wines, spirits, or
coffee. A little gum is useful, kept in the pocket
and swallowed occasionally during the day.

There are few cases in which these means will
not at least give some relief, even if they do not
cure, but it may not be immediate. This is a fact
that should be borne in mind, so that discourage-

EXCESSIVE SEMINAL LOSSES. 295

ment should not be felt because the good is not ex-
perienced at once. The disease it should be remem-
bered has nearly always existed a long time, and
has assumed a chronic form, so that it can only be
successfully attacked in a gradual manner, by
slowly producing a change in the action of the parts.

Nevertheless, I have known many benefitted
almost immediately, and very often I hear the re-
mark, that in one week from the time of commenc-
ing the treatment, the emissions decreased one half
in frequency. To ascertain the extent of the im-
provement, and as a guide to the physician, every
one afflicted in this way should keep a diary, or date
the times when the emissions occur, so that it can
be seen whether they are really decreasing in fre-
quency or not.

One of the best means for applying cold water,
both for the purpose of strengthening the genitals
and also for relieving constipation, is by means of
what is termed the ascending douche ; that is by a
stream or jet directed upwards. This must be
made to play forcibly on the Perineum, and against
the Anus, by the patient sitting over the jet. The
effects of this treatment, after a time, are often
strikingly beneficial. I have known patients who
had previously never passed a night without emis-
sions, remain for two weeks without experiencing
anything of the kind ; and I have known the most
obstinate constipation, in some instances of near
three weeks' duration, completely cured by it in
less than a month. It is in fact one of the most
valuable remedies we possess in the treatment of
Spermatorrhoea, and has cured more than, perhaps,
all other means put together. Those who cannot
employ a proper apparatus may use a large and

296 EXCESSIVE SEMINAL LOSSES.

powerful syringe, bent at right angles, so that the
jet can be thrown up against the Perineum, Scro-
tum, and Anus. It should be used morning and
night, for about five minutes. The man, mentioned
in the last article, who had been impotent for nins
years, owed his cure to this cold douche. I have
often found nothing else necessary, even in very bad
cases, except proper attention to the diet and regi-
men.

In case of worms in the rectum, which often
keeps up Spermatorrhoea by their irritation, there
are few things that succeed better in dislodging
them, and subduing the irritation, than enemas of
cold water. These seem to paralyze the worms, so
that they lose their hold and are expelled with the
fluid as it returns. They also cool and give tone
to all the neighboring parts in a very marked man-
ner, and are in short valuable remedies in the
treatment of Spermatorrhoea. In some instances
they will cause erections from the very first, though
the person may have previously been almost impo-
tent.

When the loss evidently occurs more from
general weakness than from irritation the plan of
treatment must be somewhat varied. Warm bath-
ing may then be advised, with a generous diet of
meat and wines, and the occasional administration
of tonics and bitters. Galvanism is also of very
great service in many of these cases of debility,
applied directly to the parts, or to them and the
spine. It will frequently impart a feeling of
warmth and vigor from the very first, and restore
the natural powers sooner than almost anything else.
The patient should, however, be particularly cau-
tioned not to use any of the stimulating medicine,

EXCESSIVE SEMINAL LOSSES. 297

cordials, and tonics, so urgently recommended for
this debility. These are mostly composed of Span-
ish files or Phosphorus, and are very hurtful,
though they may appear to do good for a time.

Several of the mineral waters are highly useful
in Spermatorrhoea, especially those that contain iron.
And those that contain sulphur are also of service
when used as baths.

When there is any considerable nervous irrita-
bility, with restlessness, loss of sleep, or bad dreams,
a narcotic may be of service. A few drops of
laudanum may be taken at bed-time, or some of the
camphor and opium pills, directed in a former
article. If the stomach cannot bear opium it may
be given as an enema, either by putting a few drops
of laudanum in some starch-water, or by using a
de-coetion of poppy-heads. Some patients even
introduce an opium pill, containing one grain, into
the rectum at bed-time, and leave it there till
morning. This will frequently prevent emission,
but it is apt to act too strongly on some persons.

Occasionally setons are of service, placed inside
the thighs, or acupuncture with needles, but these
must always be directed and applied by the phy-
sician.

The position in bed is frequently of some con-
sequence in very irritable persons, and should be
attended to. There is no doubt but that lying on the
hack is very apt to cause pollution, by the heat it
produces in the loins, and sometimes it will con-
tinue it notwithstanding everything else that can be
done. So well aware are some persons of this that
they invent peculiar contrivances to prevent them
ever resting on the back, even for a moment. One
of my patients used to wear a broad leather belt at

298 EXCESSIVE SEMINAL LOSSES.

night, with spikes on the inside behind, so that if he
turned on his back while asleep, these hurt him and
waked him up. Another wore a pointed piece of
wood, so adjusted that he could not turn on his back
at all, and by these means he avoided the emissions
that used to occur almost nightly. Sometimes it is
sufficient to merely sleep upon a hard mattress,
with a piece of oiled silk, or india rubber cloth
under, to keep the parts cool ; or what is still better
a sheet of lead may be tied over the back and loins
when retiring. I have known some patients speak
very highly of the effects of this metallic shield.

When there is decided irritation of the genital
organs, manifested by redness at the end of the
penis, burning when making water, and mucus
discharge from the urethra, it becomes of the first
moment to prescribe a proper diet, consisting chiefly
of milk. This should be used freely, both as food
and drink, either thickened with rice, isinglass, or
sago, or even with gum-arabic. The benefical
effects of this article will soon be evident in the
decrease of all the inflammatory symptoms. Very
little meat must be used with it, but plenty of
potatoes, which are not only nutritious, but have
also a decidedly good effect on the urine. Some
fruits are very excellent, particularly strawberries,
and ripe peaches, and so are tomatoes, but any very
acid ones are objectionable. If the milk disagrees
with the stomach a little, which it will sometimes
do, a few grains of magnesia may be added to it, or
two or three spoonfuls of lime-water, which will
generally correct all such tendency. The copaiva
and magnesia pills may also be used, or the pow-
ders of bearberry leaves, as formerly directed.
Wines, coffee, spices, and spirits must be rigidly

EXCESSIVE SEMINAL LOSSES. 299

avoided in all such cases, and in fact every kind of
excitement, as far as possible.

Cauterization. — This is a process which usually
is resorted to when all other modes of treatment
fail, though some physicians practice it from the
first. To understand how it operates the action of
caustic, when applied medicinally, must be borne
in mind. If we have any diseased surface, such
as an open ulcer, or an inflamed mucous membrane,
the caustic not only burns off that diseased surface,
but by its energetic action so alters the condition of
the parts that the disease is frequently removed
altogether. This is why it is applied to all virulent
sores, and to inflamed sore throats, eyelids, and
other parts. Now in confirmed cases of Sperma-
torrhoea there is always either a relaxed or an in-
flamed condition of the Ducts, Urethra, or Vas De-
ferens, and it is evident that if the caustic can be
applied to them, in a proper and efficient manner, it
will in all probability affect them in the same way
that it does other parts when similarly diseased.
The great difficulty, however, is to find a means to
apply it in the situation required. The ducts being
placed at the bottom of the urethra, completely out
of sight by any means, and with great difficulty ever
reached, it becomes a question as to how they are
to be operated upon. This has been decided, how-
ever, by M. Lallemand, who has invented an instru-
ment which enables us to apply the caustic to the
ejaculatory ducts, with almost as much certainty as
to any place on the exterior. This instrument
consists of a silver tube, open at the end, and
adapted to the size of the passage, down the inside
of which passes a kind of piston, furnished at the
end with a piece of lunar caustic. When the tube

300 EXCESSIVE SEMINAL LOSSES.

is introduced into the urethra, the caustic is con-
tained inside of it, but when the open end of the
tube has reached the ducts the piston with the caus-
tic on it is pushed out a little way for a moment,
and of course burns the surrounding parts ; it is
then drawn back into the tube and the whole appa-
ratus is immediately abstracted. By these means
the ducts, the mouths of the prostatic vessels, and
the neck of the bladder are effectually cauterized
without any of the other parts being touched. The
performance of this operation is certainly a little
difficult, and requires great manual skill with an
intimate knowledge of the structure of the parts.
An unskilful person, who could not properly manage
the instrument, or not judge correctly of the proper
distance to introduce it, might not only fail of doing
good but even do harm. Many practitioners also
cause great mischief by letting the caustic remain
too long, and burning too much, or by acting only
on the healthy parts and leaving the diseased ones
untouched. In short, though the operation is fre-
quently of the greatest benefit, when properly per-
formed, and capable of effecting a complete cure in
the very worst of cases, it is also exceedingly dan-
gerous when improperly performed, as too many
know. Not only may the irritation be made much
worse, but the most severe inflammation may fol-
low from it, so as to prevent the discharge of urine,
and lead to abscesses and ulcers of the most incura-
ble kind. Even in successful cases, and under the
most favorable circumstances, great distress is
nearly always experienced, and the pain is not un-
frequently very severe. Many persons are much
alarmed, and even though greatly benefitted, cannot
bring their mind to submit a second time to it.

EXCESSIVE SEMINAL LOSSES. 301

In general, however, one operation is sufficient,
and when a repetition is required, it should seldom
be under six weeks or two months after. I have
seen patients in a miserable state who had been
cauterized too frequently, and with too short in-
tervals, and in all probability much more evil
has been done by the process, in this mode, than
good by the proper mode. My own opinion is that
in proper hands, it is quite safe, and generally bene-
ficial, but that with timely attention, and with a
rigid observance of proper simple treatment, it is
seldom needed. M. Lallemand, thinks that with-
out the caustic two-thirds of the cases of Sperma-
torrhoea would be incurable, but I do not agree with
him in this.

26

302

CHAPTER VIII.

THE INFLUENCE OF MEDICINES IN PRODUCING
AND CURING IMPOTENCE AND SPERMATOR-
. RHGEA.

There are a few medicinal substances that act in
a direct manner upon the genital organs, some
beneficially and others hurtfully, but the greater
number operate upon them indirectly. This is a
subject about which there is great ignorance, as I
before stated, and an immense deal of imposition
and pretension, both among empirics and regular
practitioners. It has always been a favorite notion
with the public, and one that has been often encou-
raged by medical men, from interested motives,
that there are specific medicines capable of arous-
ing the sexual ardor under almost any circum-
stances. From this notion has originated all the
various cordials, stimulants, and elixirs, that are
constantly pressed upon the attention of the impo-
tent and sterile. None of these things are in the
slightest degree capable of accomplishing what is
promised of them, as well-informed people are
aware, but the public generally are deceived and
much injured thereby. Very lately it has been
ascertained that certain drugs can be made to have
a remarkably beneficial action, in particular cases
of loss of power, but each case requires a peculiar
dose and mode of administration, which makes it
impossible to prescribe for all alike. These agents,
however, are probably not known, even by name,

INFLUENCE OF MEDICINES. 303

to the parties who compound the preparations
above referred to, and it is fortunate they are not,
for if they were, more mischief would be done than
by the things now used. There is no doubt but
that an immense deal of disease and incurable im-
potence is caused by the use of these preparations,
and much good will result from cautioning the pub-
lic against them.

It is not only the action of those drugs that may
be beneficial that we have to study, however, but
also those that may be hurtful, and among them
will be found many that few persons have suspected
of having any influence on the genital organs at ail.
Purgatives, for instance, are popularly thought to
act only on the bowels, and not to influence sexual
vigor at all, but the fact is, they often exert a very
marked influence in that way. It is well known
that aloes, gamboge, colocynth, and several other
purgatives irritate the bowels very much, and this
irritation may be extended to the neighboring parts,
particularly near the rectum, and in this way they
excite the flow of urine in some, persons, by irritat-
ing the bladder, as well as operate upon the bowels.
Now the spermatic ducts, and prostate gland, lie
close to the rectum, and of course are subjected to
this irritation as much as the bladder, and are
equally liable to become unusually sensitive. I
have known many persons in fact who always had
involuntary emissions when they took purgatives,
and who were obliged to be exceedingly careful in
consequence when they did so. When there is
any tendency to Spermatorrhoea, therefore, the pos-
sible effect of purgatives must be borne in mind,
both by the physician and patient, and when they
are absolutely needed those must be chosen that are

304 INFLUENCE OF MEDICINES.

least irritating, particularly to the lower part of the
bowels.

Tobacco is an article that exerts a most decided
action, in numerous cases, upon the generative
organs, though few persons suspect it of doing so.
Like opium, and some other narcotics, it often
stimulates at first, but afterwards greatly weakens
the sexual power, so as to bring on complete impo-
tence in many cases. I am satisfied, from my own
observations, that it frequently leads to involuntary
emissions, and keeps them up notwithstanding all
that can be done for them. Many young men,
patients of mine, have remarked that a cigar at
bed-time would be certainly followed by emission
before morning, and they found it necessary in con-
sequence to abandon its use. It is true that these
results are not generally seen except the tobacco is
used in great quantity, but there are some persons
that are affected by a very small portion, and who
therefore never surmise that it has any influence
upon them at all. I once saw a young man, a great
smoker, who suffered from constant pollution, and
who had been perfectly impotent for five years. He
had submitted to every kind of treatment, even to
cauterization, but only obtained temporary relief,
and at last totally despaired of ever being benefitted.
On hearing his statement, and learning what had
been done for him, I was much surprised, because
there were no indications of severe disease, nor
were the parts themselves in an unhealthy condi-
tion, though relaxed, and the Testes still secreted
perfect semen in considerable quantities. During
our conversation he accidentally alluded to his
smoking habits, and said he frequently used from
two to four dozen cigars a day. I was immediately

INFLUENCE OF MEDICINES. 305

struck with the similarity of his case to that of a
great opium chewer whom I had seen, and I at once
concluded that the tobacco was the cause of the
mischief. On explaining this to him he could
scarcely be brought to think it possible, but even-
tually he agreed to follow my advice and gradually
leave it off. The result even exceeded my expec-
tations, for I was much afraid that some permanent
mischief had been done. He began to mend im-
mediately, and though considerable lowness of
spirits, weakness, and loss of sleep was experienced
at first, yet all these effects ultimately passed off and
he felt better, and was stronger than while using
the tobacco. The most marked effect, however,
was the checking of the Spermatorrhoea. When I
first saw him he passed semen constantly in his
urine, and frequently in the night. He had little
or no erection, and such nervous palpitation of the
heart occurred, whenever any slight sexual feeling
was experienced, that he became utterly powerless,
and would undoubtedly have been impotent from
that cause alone. This all passed off, the involun-
tary discharge ceased, and his sexual powers re-
turned as strongly as ever. Contrary to my advice
he commenced using the tobacco again, thinking
that it would now cease to affect him, but in three
days all the old symptoms returned, and he became
as impotent as ever. On leaving off his smoking,
however, he gradually recovered again, though with
more difficulty than at first, which made me caution
him not to relapse again, for fear the re-action might
eventually fail altogether. I have even known
married men seriously injured in this way, by
merely using tobacco as a domestic indulgence. In
one instance a gentleman, engaged in a somewhat

26*

306 INFLUENCE OF MEDICINES.

harassing business, was induced by a friend to
smoke a few cigars at night, to steady his nerves !
He found, however, that though he could readily
stupify himself, yet his nerves were no steadier,
particularly in the morning, and what was most sin-
gular, to him, he lost all sexual power and desire,
and became so weak he could scarcely stand. In
this dilemma he consulted me, and gave me a full
history of his proceedings and experience. On ex-
amining his urine I found, as 'I expected I should,
that the semen escaped with it, and in such quanti-
ties that his impotence and weakness were no longer
to be wondered at. I at once told him to leave off
his tobacco, gave him a slight tonic, cauterized the
ducts, and directed him to go and bathe in the salt
water for a few weeks. He did so and returned
perfectly cured.

I could, in fact, give numerous cases, both among
single and married, showing the effects of this
poisonous drug, and I do not hesitate to say that I
think it has more to do with many of these com-
plaints than has been hitherto supposed.

In the thirteenth Annual Report of the Massachu-
setts State Lunatic Assylum, are some excellent
remarks on the use of tobacco, which, though they
are intended to apply chiefly to its influence in pre-
disposing to insanity, are nevertheless of great
general interest, and I therefore quote them :

" Alcohol is not the only narcotic which thus af-
ects the brain and nervous system. Opium produces
delirium tremens and probably insanity. Tobacco
is a powerful narcotic agent, and its use is very
deleterious to the nervous system, producing trem-
ors, vertigo, faintness, palpitation of the heart, and

INFLUENCE OF MEDICINES. 307

other serious diseases. That tobacco certainly
produces insanity, I am not able positively to ob-
serve ; but that it produces a predisposition to it, I
am fully confident. Its influence upon the brain
and nervous system generally, is hardly less obvi-
ous than that of alcohol, and if used excessively is
equally injurious. The young are particularly
susceptible to the influence of these narcotics. If a
young man becomes intemperate before he is twenty
years of age, he rarely lives to thirty. If a young
man uses tobacco while the system is greatly sus-
ceptible to its influence, he will not be likely to
escape injurious effects that will be developed
sooner or later, and both diminish the enjoyments
of life and shorten its period.

" The very general use of tobacco among young
men at the present day, is alarming, and shows the
ignorance and devotion of the devotees of this dan-
gerous practice to one of the most virulent poisons
of the vegetable world. The testimony of medical
men, of the most respectable character, could be
quoted to any extent to sustain these views of the
deleterious influence of this dangerous narcotic.

"Dr. Rush says of tobacco — 'It impairs appetite,
produces dyspepsia, tremors, vertigo, headache, and
epilepsy. It injures the voice, destroys the teeth,
and imparts to the complexion a disagreeable, dusky
brown.5

" Dr. Boerhaave says that * since the use of to-
bacco has been so general in Europe, the number
of hypochondriacal and consumptive complaints has
increased by its use.5

" Dr. Cullen says, 'I have known a small quan-
tity snuffed up the nose to produce giddiness, stupor
and vomiting. There are many instances of its

308 INFLUENCE OF MEDICINES.

more violent effects, even of its proving a mortal
poison.7

" Dr. Darwin says, f It produces disease of the
salivary glands and the pancreas, and injures the
power of digestion by occasioning the person to spit
off the saliva which he ought to swallow.'

"Dr. Tissott once saw the smoking of it prove
fatal.

"Dr. Pilcher details the particulars of a case of
a medical student whom he had been requested to
see. ' This gentleman suffered under all the symp-
toms of phthisis. There was muco-purulent ex-
pectoration, night sweats, &c. The mucous mem-
brane of the throat, epiglottis, and the neighboring
parts, was coated with a brown fur. The patient
had been an immoderate snuff-taker ; he was told
to discontinue the snuff; he did so, and recovered.'

" Dr. Chapman says, ' By a member of Congress
from the West, in the meridian of life, and of a
very stout frame, I was some time since consulted;
he told me that, from having been one of the most
healthy and fearless of men, he had become ' sick
all over, and timid as a girl.' He could not even
present a petition to Congress, much less say a word
concerning it, though he had long been a practising
lawyer, and served much in legislative bodies. By
any ordinary noise he was startled or thrown into
tremulousness, and afraid to be alone at night. His
appetite and digestion were gone, he had painful
sensations at the pit of his stomach, and unrelenting
constipated bowels. During the narrative of his
suffering, his aspect approached the haggard wild-
ness of mental distemperature. On inquiry, I found
that his consumption of tobacco was almost incredi-
ble, by chewing, snuffing and smoking. Being sat-

INFLUENCE OF MEDICINES. 309

isfied that all his misery arose from this poisonous
weed, its use was discontinued, and in a few weeks
he entirely recovered.

" Distressing as was this case, I have seen others,
from the same cause, even more deplorable. Two
young men were in succession brought to me for
advice, whom I found in a state of insanity, very
much resembling delirium tremens.' Each had
chewed and smoked tobacco to excess, though per-
fectly temperate as regarded drink. The further
account given me was, ' that in early life, adopting
this bad practice, it grew with their growth. Dys-
pepsia soon occurred, attended by great derange-
ment of the nervous system, and ultimately the
mania I have mentioned. But I have also seen the
same condition very speedily induced.'

" Dr. Franklin says he never used it, and never
met with a man who did use it that advised him to
follow his example.

" The venerable John Qnincy Adams, iu a recent
letter on the subject, says that in early life he used
tobacco, but for more than thirty years he had dis-
continued the practice. * I have often wished,'
says he, ' that every individual of the human race,
affected with this artificial passion, would prevail
upon himself to try, but for three months, the expe-
riment which I have made, and am sure it would
turn every acre of tobacco-land into a wheat-field,
and add jive years to the average of human life.5

" Some cases have come under my observation
which show the injurious effects of tobacco where
no evil was suspected.

" A respectable merchant, who abstained wholly
from ardent spirits, applied to me for advice. He
complained of great weakness, tremor of the limbs

310 INFLUENCE OF MEDICINES.

and joints, with lassitude, general prostration of
health, and depression of spirits. Knowing that he
used tobacco freely, I advised him to discontinue
it entirely ; he soon became better, and after a
time was wholly relieved from these disagreeable
symptoms.

" A distinguished clergyman informed me that he
had been an extravagant snuff-taker ; that for years
he had had a disagreeable affection of the head, and
his health was not good. He did not attribute either
to his use of snuff, but thinking it a filthy habit and
a growing evil, he resolved to leave it oil*. He was
surprised to find the difficulty in his head almost
immediately left him, and his general health became
quite good.

" A gentleman of athletic frame, and about
twenty-four years of age, applied to me for advice.
He complained of insufferable faintness and distress
of stomach, morning-sickness, vomiting, trembling
and prostration of strength. He diminished his to-
bacco considerably, and was immediately better,
but had not resolution to abandon the pernicious
practice.

" In our experience in the Hospital, tobacco in all
its forms is injurious to the insane. It increases
excitement of the nervous system in many cases,
deranges the stomach, and produces vertigo, trem-
ors, and stupor in others. It is difficult to control
its use with the insane, and though considerable suf-
fering comes from its entire abandonment, it cannot
be generally allowed with safety.

" One patient, while at labor, found a quantity
of tobacco, and hid it in his bed. He used it freely,
became sick, lost his appetite, and confined himself
to his bed completely intoxicated. After some days,

INFLUENCE OF MEDICINES. 311

diligent search was made, and a store of tobacco
was found in his straw-bed ; when this was removed
he almost immediately recovered, and in a few days
was well as before.

" A person who came into the Hospital a furious
maniac, soon became calm and improved favorably.
He labored in the field with propriety, and exhi-
bited every indication of a favorable convalescence.
Suddenly, without any apparent cause, he again be-
came very violent and insane. It was soon discov-
ered that he had in some way obtained tobacco.
After he ceased to use it, he again became calm
and convalescent.

"An aged lady was brought to us very insane.
The practice of her friends for some time had been
to give her ardent spirits to intoxicate her at night,
and tobacco and snuff, in unlimited quantity, for the
day. All these were withdrawn at once ; her suf-
ferings for some days were great ; but after a time
she became calm, and got better as soon as the influ-
ence of this excitement was over.

" I have already exceeded my intended limits in
the detail of cases.

" It is very natural to suppose that an article pos-
sessing the active properties of this fascinating nar-
cotic, should produce most deleterious effects upon
health — particularly upon the brain and nervous
system.

" The uninitiated cannot smoke a cigar, or use
tobacco in any form, without unpleasant effects, —
how then can it be possible that a poison so active
can be used with impunity ? The stomach and
brain, subjected to such influences, will become dis-
eased, and show their effects as certainly as if alco-
hol were used. If asked my medical opinion, which

312 INFLUENCE OF MEDICINES.

was safest, four glasses of wine or four quids of
tobacco, daily, I should say unhesitatingly the wine.
Of the two evils, this would, in my opinion, be the
least. Tobacco is the strongest, most dangerous
, narcotic — the habit of its use is the strongest and
most difficult to overcome, and the influence felt from
it most baneful and destructive to health."

Opium acts similarly to tobacco, but much more
fatally, the exhaustion caused by it being much less
readily recovered from. In fact if a man once be-
comes impotent from using opium it is a great
chance if he ever recovers his powers.

Dr. McDougal says that many of his friends,
inveterate smokers, have remarked to him that a
decrease of their sexual desires was one of the
marked effects of their indulgence, and I have fre-
quently been told the same. M. Lallemand also
gives several instructive cases in which this fact is
forcibly illustrated. The following is a counterpart
of many that I see : —

" I have a young man of very nervous tempera-
ment at present under my care, in whom nocturnal
and diurnal pollutions have brought on pain in the
loins, palpitation, difficulty of breathing, &c, symp-
toms which were supposed to arise from disease of
the spinal cord, cardiac affection, and commencing
phthisis. Among the exciting causes of these in-
voluntary discharges, the effects of smoking occupy
the chief place. The following is the patient's
statement.

" ' At twenty years of age I wished to accustom
myself to smoking ; but a day never passed without
my experiencing complete intoxication, attended
with vomiting, vertigo, and trembling of the limbs.

INFLUENCE OF MEDICINES. 313

I continued the habit, however, and I soon began to
perceive that my sight became weak, and that I
lost my memory ; my hands shook ; and my diges-
tion became much disordered. I noticed also, great
debility of the genital organs ; my erections ceased ;
and at the age of twenty-two I found myself com-
pletely impotent.' This patient had rarely prac-
tised masturbation, and had never committed any
excess when he first began to smoke ', his health
had, previously, been excellent. It is, therefore,
evident that the impotence, . as well as the other
symptoms, arose from the action of tobacco. Im-
potence at the age of twenty-two can only be pro-
duced by involuntary seminal discharges, provided
there be no physical disability. In the present case,
there was no doubt on the point, the patient himself
having discovered diurnal and nocturnal pollutions.

" The action of tobacco on those who smoke for
the first time, is too well known to require descrip-
tion ; more or less disorder of all the functions, va-
rying according to the constitution of the individual,
invariably arises from it ; and this disorder always
presents more or less of the characteristics of poi-
soning by narcotics. These effects go off by de-
grees, as the patient becomes habituated to the use
of tobacco, and generally after a time cease to be
manifested at all. Some nervous and excitable in-
dividuals are unable to accustom themselves to the
habit, as in the case just mentioned ; in others
again, smoking becomes an artificial habit, which
in many cases is almost a necessity.

" But this empire of custom has its limits, beyond
which, the narcotic influence re-appears. In such
as are not easity affected, this acquired habit is ge-
nerally supported with impunity ; but even then, if

314 INFLUENCE OF MEDICINES.

it be indulged in to excess, it must after a time be
injurious. Thus it is that the most accomplished
smokers often experience vertigo, cephalalgia, ano-
rexia, &c, when they have remained long in an
atmosphere densely filled with smoke, which is then
drawn into the lungs, and probably produces worse
effects than when merely drawn into the mouth, or
swallowed, as in smoking.

" In a word then, if the power of habit can pre-
vent the momentary effects of smoking from show-
ing themselves, the frequent repetition of the use
of tobacco produces more lasting effects on different
organs. Disorder of the digestive organs is well
known as occurring in inveterate smokers ; that of
the genital organs has not hitherto been noticed.
[Many inveterate smokers among my professional
friends, have mentioned to me the diminution of
their venereal desires, as one of the effects of to-
bacco. I believe, however, that it is by no means
rare." H. J. MoD.]

Cantharides, or Spanish Flies. This article* is
popularly supposed to have an undoubted stimulating
effect upon the sexual powers, and many persons
will be surprised to learn how little foundation there
is for such a belief. In fact upon most persons
Cantharides have but little or no effect at all in that
way ; except they are given in such quantity as to
be poisonous, and then they only act by causing se-
vere inflammation, not only on the genitals but also
in all the neighboring parts. It is quite common
for even a small dose to create great irritation of the
bladder, with complete inability to discharge the
urine, and this may take place without any unusual
sexual excitement at all, though most usually the

INFLUENCE OF MEDICINES, 315

generative organs are stimulated more or less. — It
is a great mistake, therefore, to suppose that Can-
tharides have a constant and specific action on the
sexual organs, for they merely create an intense
irritation, which affects these organs along with
others, in the same way that many other irritant
poisons do. — All the popular notions on this subject
are utterly unfounded, and quite opposed to the truth.
It is very seldom that Cantharides are of any ser-
vice whatever in the treatment of Impotence or
Spermatorrhoea, though a combination of these with
other articles is useful in certain cases. They form
the main ingredient in all the quack stimulants for
the generative organs, and the use of them in this
way unfortunately causes great mischief. Num-
bers of young men are permanently ruined, from
Spermatorrhoea, through taking* these preparations
of Cantharides, and I have known many married
persons rendered hopelessly sterile from using them
as stimulants. I had one distressing case of a
young man, who was persuaded by a thoughtless
friend to take some Spanish Flies as an experiment,
to see if they would not increase his desires and
powers. The quantity he took was only a moderate
dose, but the effects were most alarming. He com-
pletely lost all power of discharging the urine,
though the Bladder was full almost to bursting, and
experienced such agonizing pain in the prostate and
urethra that he was nearly delirious. Priapism
took place, but so far from being attended by in-
creased pleasure that it added to his sufferings, and
yet he could not prevent it. Fortunately he had
timely assistance, and the immediate danger was
obviated, but immediately after he began to be trou-
.bled with involuntary emissions in the night, and

316 INFLUENCE OF MEDICINES.

eventually when urinating, so that he became com-
pletely impotent, and so weak he could scarcely
stand. I cauterized him, and used every other
means the case would allow, but in spite of all, the
trouble continued to some extent, and probably
always will. He had been suffering, however,
over four years when I saw him.

I also had a case of a young person of the other
sex, who was seriously injured by Cantharides,
given as a trick, and who had involuntary discharge
of urine ever afterwards.

Camphor. — The action of Camphor upon the gen-
ital organs is sedative rather than stimulant, and
when taken improperly or in excess, it may almost
entirely destroy the sexual feeling, at least for a
time. It is therefore given in cases of priapism,
and in excessive excitement, whether from sexual or
physical causes. If Cantharides or any other irri-
tating poison be taken, Camphor is usually a valua-
ble palliative, and it is sometimes of great service
in certain forms of Spermatorrhoea. If taken in
too large doses, however, or for too long a time, it
will cause involuntary emission.

Nitrate of Potash or Saltpetre. — It is commonly
supposed that this substance acts as a direct seda-
tive to the sexual organs, and that if taken in any
considerable quantity, it will destroy all feeling, but
this notion is a very erroneous one. Like all other
diuretics Nitre stimulates the Genital Organs, and
if taken in too large doses it will even produce in-
flammation, like Cantharides. Instances have been
known where a discharge from the urethra has fol-
lowed its use, like that of Gonorrhoea, and after-
wards involuntary emissions have been experienced.

Ergot of Rye, or Secale Cornutum. This sub-

INFLUENCE OF MEDICINES. 317

stance, as is well known, is used to expedite de-
livery in females, which it does by increasing the
action of the womb. Its use, however, is dangerous,
except in proper hands. From recent observations
it appears to stimulate the male organs also, and the
men of those parts where it grows among the rye
are noted for their ardent desires, while the females
frequently miscarry. The Ergot cannot be given
alone, either with safety or advantage, but its com-
bination with other articles, forms a valuable re-
medy, both for impotence and for spermatorrhoea.
It is one of the ingredients of a stimulating and
invigorating medicine which I use extensively in
my practice.

Coffee and, Tea. — Both these articles, but espe-
cially coffee, act as direct stimulants to the genera-
tive organs, and if taken in excess may produce all
the effects of the most powerful drugs. I have
known coffee cause priapism, lascivious dreams,
and involuntary emissions, and nearly always its
continued use will counteract any treatment that
can be followed for relief.

Phosphorus. — This article is similar in its action
to cantharides, but much more energetic, and con-
sequently it is much more dangerous in wrong
hands, but when properly administered it is fre-
quently of great service. It is one of the ingre-
dients of the invigorating medicine which I formerly
spoke of, with which I have often produced the
most unexpected restorations to power and health.
Phosphorus should, however, never be experimented
with by those not familiar with its action, for in
some cases it will lead to the most disastrous con-
sequences, and its evil effects are not easily re-
covered from.

27*

318 INFLUENCE OF MEDICINES.

Aromatics and Spices. — These have in general a
stimulating effect on the generative organs, the
same as on other parts, but their power varies very
much in different persons, and under different cir-
cumstances. There are various spice mixtures and
combinations in popular use for this purpose, but
they should not be indiscriminately used. Some-
times they are highly injurious, like all other stimu-
lants, and even when they do cause an increase of
power or feeling it is only temporary, and often fol-
lowed by directly opposite effects.

In short none of these articles operate specifically,
in a beneficial manner, on the generative organs,
though certain combinations of them may do so
under particular circumstances, like the medicine I
have referred to as being used in my own practice.

There is one drug brought from the East Indies,
the Cannabis I?idica, which is the most regular in
its action, and produces the most constant beneficial
effects of anything yet tried. It appears to act as a
special nervous stimulant, exciting that part of the
brain which influences the sexual organs, so that
they feel directly an increase of power. It also
causes great mental activity, disposes to cheerful-
ness, and induces a feeling of warmth and comfort
over the whole system. Those who have taken it
in a proper manner, are delighted with its effects,
and never complain of any after-depression or re-
action in any way. If given improperly, however,
or in too heavy a dose, it first causes excitement of
the wildest character, with an uncontrollable dispo-
sition to bodily activity, and afterwards a complete
mental and physical prostration. In short it is most
powerful, either for good or for evil, according as it
is used, and is the only means we possess, in numer-

INFLUENCE OF MEDICINES. 219

ous cases, of restoring sexual power and desire. In
the East Indies it is commonly used, like opium is
in China, for the purpose of producing pleasurable
excitement, and also for removing impotence.

A plant producing this drug grows in the
United States, and with due care a similar prepara-
tion may be made from it to that received from the
East Indies. I have experimented with both, and
when prepared by myself I have found the native
product fully equal to the foreign. The Botanic
physicians use this plant for various other purposes,
but none of them seem to be aware of its possessing
the properties I have described. * Indeed the way in
which they prepare and administer it prevent those
properties from being exhibited.

Medicines that excite the sexual organs are called
Aphrodisiacs, and in various parts of the world they
are in great demand, though but seldom adminis-
tered, so as to be of any real service. As I have
already remarked some of these medicines, when
properly used, have undoubted aphrodisiac powers,
but they are by no means applicable in all cases.
They may frequently fail of producing any good
effect whatever, and sometimes may even cause ir-
retrievable mischief. The successful administration
of them therefore requires a perfect knowledge of
their properties, and an extensive observation of
their effects under all circumstances. It is for this
reason I have not given any recipes for these drugs,
for no one can tell when they should or should not
be used unless they know something about them, and
the effects of taking them improperly may be so
serious that mere experiment with them is highly
hazardous.

In a particular class of cases I have long been

320 INFLUENCE OF MEDICINES.

using a combination of the Cannabis, with other
articles, which I find to possess the most extraordi-
nary powers, the preparation of which I have been
repeatedly importuned to disclose, both by patients
and medical men. At present, however, I do not
feel called upon to make this disclosure, because I
know the great mischief which would result from
using such a preparation improperly, and I know
also how few persons there are familiar enough with
its powers and properties to use it rightly. My
own experience has made me acquainted with signs
by which I can tell, in every case, whether it is
proper to be used or not, and I will answer for its
never producing evil effects when I advise it. So
wonderful and unexpected have been the effects of
this preparation, in numerous instances, that if I
chose to be unscrupulous and sell it indiscriminate-
ly, I have no doubt but it would be used more
extensively than any other medicine has ever been,
for any purpose whatever. I do not think it proper
to give it, however, in any case, till I know whether
it be appropriate or not, and this I can always tell
on receiving either a verbal or written description
of the history, progress, and symptoms of the dis-
ease. I do not hesitate to say that I have seen
more restorations to sexual power, and more cures
of Sterility, in both sexes, from the use of this pre-
paration than from any other means, and I do not
hesitate to pronounce it, in certain cases, an infal-
lible remedy.

Medicines that decrease the sexual powers are
called An-aphrodisiacs, and I believe they have all
been mentioned.

321

CHAPTER IX.

MASTURBATION AND OTHER SEXUAL ABUSES.

A very few years ago only it was thought wrong
even to allude to snch a subject as masturbation,
much less to openly speak or write about it. For-
tunately, however, people have become more ra-t
tional, and now begin to see that this and similar
practices are of the most hurtful character, and that
no successful efforts can be made for their removal
till they are more fully and generally understood.
Various books have been published, lectures have
been delivered, and even sermons have been preached
bearing upon this subject, till much general informa-
tion about it is now disseminated, and a very gene-
ral desire is expressed for something more complete
and scientific than has yet appeared. — The greater
part of the books written on the subject of Onanism
or Masturbation, are very incomplete, and not ac-
companied by those physiological and medical de-
tails that are requisite to give a clear view of the
evil. The effects of this vice may be partly given
in such works, though in an incomplete form, but
the manner in which they are produced, their con-
nection with other evils, and the philosophy of their
treatment, cannot be understood without such a work
as the present. I have, therefore, delayed speaking
upon this subject till all the other topics have been
introduced, so that the unnatural character of the
vice, and its terrible consequences, may be clearly
obvious.

322 SEXUAL ABTJSES.

The mere tolerance of discussion on this subject
was a great point gained, and was soon followed by
a general conviction that such a discussion was not
only desirable, but imperatively demanded by the
best interests of society. It is both curious and in-
structive to see how this tolerance has been gradu-
ally gained, and how a perception of the manifold
evils of self-abuse has extended, though slowly,
from a few . philosophers to the great mass of the
medical profession, and from thence to non-profes-
sional persons, till at last it has even been made the
subject of legislative action.

I shall now proceed to show, by extracts from an-
cient medical writers, how this subject was regarded,
by eminent minds, in former ages, and then to exhi-
bit the more perfect knowledge, and greater interest
of modern times, including the approval, by exist-
ing legislators, of investigations bearing intimately
upon it.

Several of these extracts are taken from the cele-
brated works of Tissot and others, and being from
the writings of the Fathers of Physic, many of
whom lived centuries before Christ, allowance must
be made, in some few cases, both for unintentional
exaggeration, and also for deficiency in scientific
accuracy. Generally speaking the statements are
fully authorized, and the pictures by no means
overdrawn ; in fact it is often the case that the whole
truth is not told, simply because it was not known.

" Hippocrates, the oldest and most correct obser-
ver, has already described the diseases produced by
abusing the pleasures of venery, under the term,
dorsal consumption. i This disease,' says he,
' arises from the dorsal portion of the spinal mar-

SEXUAL ABUSES. 323

row. It principally attacks young married people,
or the licentious. They have no fever, and although
they eat well, they grow thin and waste away.
They have a sensation of ants crawling from the
head down along the spine. Whenever they go to
stool, or evacuate their urine, a considerable quan-
tity of very thin seminal fluid escapes from the
urethra. They lose the power of procreation, yet
often dream of venereal pleasures. They become
very weak, and walking produces shortness of
breath ; they have pains in the head and ringing in
the ears ; and finally an acute fever (Libiria)
supervenes and they die." We shall mention this
fever in another place.

" Some physicians have ascribed to the same
cause, a disease which he has described, in another
place, and have termed it, the second dorsal con-
sumption of Hippocrates, and which has some rela-
tion to the first. But the preservation of the strength
which he mentions particularly, seems to us a con-
clusive proof, and this disease does not depend on
the same cause, but seems. rather to be a rheumatic
affection.

" ' These pleasures,' says Celsus, in his excellent
work on the preservation of health, l are always
injurious to weak persons, and their abuses pros-
trate the strength.' We can find nothing more
frightful, than the description, by Aretseus, of the
diseases produced by a too abundant evacuation of
semen. ' Young persons assume the air and the
diseases of the aged ; they become pale, stupid,
effeminate, idle, weak, and even void of understand-
ing ; their bodies bend forward, their legs are weak,
they have a disgust for everything, become fit for
nothing, and many are affected with paralysis.' In

324 SEXUAL ABUSES.

another place he mentions the abuse of these plea-
sures among the six causes which produce paralysis.
, " Galen has seen diseases of the brain and nerves
from the same cause, and the powers of the body
impaired ; and he also relates that a man who was
convalescent from a violent attack of disease, died
the same night after coition with his wife.

" Pliny, the naturalist, informs us that Cornelius
Gallus, the old praetor, and Titus Etherius, a Roman
knight, died in the act of copulation.

" Aetius says, ' the stomach is deranged, all the
body wastes, becomes pale, dry, and the eyes
sunken.' These remarks of the most respectable
ancient writers are confirmed by the moderns.
Sanctorious who has examined, with the utmost
care, all the causes which act on our bodies, has
observed, that this weakens the stomach, destroys
digestion, prevents insensible perspiration, the de-
rangements of which produce such evil conse-
quences, disposes to calculus diseases, diminishes
the natural warmth, and is usually attended with a
loss, or derangement of sight.

" Lomnius, in his fine commentaries on the pas-
sages of Celsus, whom we have just cited, supports
the remarks of the author by his own observations.
' Frequent emissions of semen relax, weaken, dry,
enervate the body, and produce numerous other
evils, as apoplexies, lethargies, epilepsies, loss of
sight, trembling, paralysis, and all kinds of painful
affections.'

" One cannot read without horror the description
left us by Tulpius, the celebrated burgomaster and
physician of Amsterdam. ' Not only,' says he,
" the spinal marrow wastes, but the whole body and
mind becomes languid, and the patient perishes in

SEXUAL ABUSES. 325

misery. Samuel Vespertius was attacked first with
a humor upon the back of his neck and head ; it
then passed to the spine, to the loins, to the lower
and lateral region of the abdomen, and to the hips ;
this unhappy man was affected with so much pain,
that he was entirely disfigured, and was emaciated
so gradually by a slow fever, that he more than
once asked to be relieved from his misery by
death.'

" Nothing says a celebrated physician of Lou-
vain, weakens the system so much.

" Blancard has known simple gonorrhoeas, drop-
sies, and consumptions, to depend on this cause ;
and Muys has seen a man of good age attacked with
spontaneous gangrene, of the foot, which he attri-
buted to the same kind of excesses.

"In the Memoir es. des Curieux de la Nature is
mentioned a case of blindness: it deserves to be
given at length. ' We are ignorant,5 says the
author, ' what sympathy the testicles have with the
body, but particularly with the eyes.' Salmuth
has known a sensible hypochondriac to become a
fool, and in another man the brain to be so collapsed
that it was heard to rattle in the cranium, both from
excesses in venery. I have known myself a man,
fifty-nine years of age, who, three weeks after
marrying a young wife, became blind, and in four
months died.

" * The too great loss of the animal spirits weakens
the stomach and destroys the appetite ; and nutri-
tion not taking place, the action of the heart be-
comes more feeble ; all parts languish, and the pa-
tient becomes epileptic' It is true we are ignorant
whether the animal spirits and the seminal fluid are
the same ; but observations show, as we shall see

28

326 SEXUAL ABUSES.

hereafter, that these two fluids are very analogous,'
and that loss of one or the other, produces the same
complaints. Hoffman has seen the most frightful
symptoms ensue from the loss of semen.- 'After
long nocturnal pollutions,' says he, ' the patient not
only loses strength, becomes emaciated . and pale,
but the memory is impaired, a continual sensation
of coldness affects all the extremities, the sight be-
comes dim, the voice harsh, and the whole body,
gradually wasted ; the sleep is disturbed by un-
pleasant dreams, does not refresh, and pains are felt
like those produced by bruises.'

" In a consultation for a young man who, among
other diseases produced by masturbation, was af-
fected with weakness in the eyes, he says, ' I have
seen several instances of young men who, at mature
age, when the body possesses all its strength, were
attacked, not only with severe pain and redness of
the eyes, but the sight became so feeble that they
could neither read nor write.' He adds, ' I have
even seen two cases of guita serena from the same
cause.' The history of the disorder which gave
rise to this consultation will be read with interest.
■' A young man commenced masturbation, when
fifteen years old, and having indulged in it till he
was twenty-three, experienced so great feebleness
in his head and eyes, that during the emission of
semen there was severe pain in the latter. When
he attempted to read anything he had a feeling
similar to that of drunkenness ; the pupil was ex-
traordinarily dilated ; the eyes were exceedingly
painful ; the eyelids very heavy, and glued together
every night ; they were often filled with tears, and
a whitish matter collected very abundantly in the
two corners which were very painful. Although

SEXUAL ABUSES. 327

he ate with a good appetite, still he was extremely
emaciated ; and after he had taken food, appeared as
if drunk/' The same «author has mentioned another
case of which he was an eye-witness, and which we
think proper to mention here. ' A young man, eigh-
teen years old, who had had frequent connections
with a servant girl, suddenly fainted and trembled
exceedingly in all his extremities ; his countenance
was red, and his pulse very small. He recovered
from this state at the end of an hour, but continued
very feeble. The same phenomena occurred very
frequently with severe pain, and at the end of eight
days there was a contraction and tumor in the right
arm with a pain in the elbow, which was always
increased during the paroxysm. The disease in-
creased for some time, but was finally cured by
Hoffman.'

" Boerhaave portrays these diseases in that mas-
terly manner and with that precision which charac-
terizes all his descriptions. ' Too great loss of
semen produces weakness, debility, immobility,
convulsions, emaciation, dryness, pains in the mem-
branes of the brain, impairs the senses, particularly
that of sight, gives rise to dorsal consumption, indo-
lence, and to the several diseases connected with
them.'

" The cases, narrated by this great man to his
auditors in explaining to them this aphorism, which
related to the different kinds of evacuations, ought
not to be omitted. ' I have seen,' says he, ' a sick
man where the disease commenced by a lassitude
and feebleness in the body, particularly in the
loins : it was accompanied by twitching of the ten-
dons, periodical spasms and loss of flesh, so as to
destroy the whole body ; also pains in the mem-

328 SEXUAL ABUSES.

branes of the cerebrum, pains which the patient
terms (ardeur seche) a dry burning, which con-
stantly inflames this most noble organ.

"I have also seen one young man affected with
dorsal consumption. His figure was good ; and
although often cautioned against indulging in these
pleasures, he did not regard it, and became so
deformed before death, that the layer of flesh which
appears above the spinous processes of the lumbar
vertebrse, entirely disappeared. The cerebrum in
this case seemed to be consumed ; in fact, the pa-
tient seemed to be stupid, and became so stiff, that
we have never seen the body so immovable from
any other cause. The eyes are so dull that the
sight is nearly lost."

" De Senac mentions in the first edition of his
Essays, the dangers attending masturbation, and
states that all who indulge in this vice will be af-
fected in the flower of their youth with the infirmi-
ties of age. We can see in the following editions
why this and other remarks of the same character
were suppressed.

" Ludwig, in describing the diseases resulting
from too frequent evacuations, does not forget that
of the semen. ' Young people of both sexes, who
indulge in lasciviousness, ruin their health by wast-
ing strength which was designed to make them
vigorous, and finally fall into consumption.'

" De Gotter details the sad accidents arising from
this cause ; but they are too long to copy. We re-
fer to the work all those who can read the language
in which it is written.

" Van Swieten, after quoting the description of
Hippocrates mentioned above, adds, ' I have seen
all these symptoms, and several others, in those un-

SEXUAL ABUSES. 329

fortunate people who indulged in self-pollutions. I
have employed uselessly, for three years, all the re-
sources of medicine, for a young man who was
diseased in consequence of this practice with wan-
dering, frightful and general pains, with a sensation
sometimes of heat, and sometimes of cold, in every
part of the body, but particularly in the loins.
Afterwards these pains having diminished, his
thighs and legs were so cold, that although they
seemed of the natural temperature when touched, he
was constantly warming himself by the fire, even
during the warmest days of summer. I noticed par-
ticularly, all this time, a continual rotatory motion
of the testicles in the scrotum, and the patient felt
a similar motion in the loins.' This account does
not mention whether this unfortunate creature died
in three years or continued to languish sometime
longer, which would be more dreadful ; he could not
have recovered.

" Kloekof, in a very fine work on the diseases of
the mind which depend on the body, confirms by his
observations what we have already mentioned. ' A
too great loss of semen weakens all the solid parts ;
hence arise weakness, idleness, phthisis, tabes dor-
salis, stupidity, affections of the senses, faintings and
convulsions.'

" Hoffman had already remarked that those
young people who practise the infamous habit of
masturbation, lose gradually all the faculties of the
mind, particularly the memory, and become entirely
unfit for study.

" Lewis describes all these symptoms. We shall
translate from his work only what relates to the
mind. ' All the symptoms which arise from ex-
cesses with females, follow still more promptly, and

28*

330 SEXUAL ABUSES.

in youth the abominable practice of masturbation,
and it is difficult to paint them in as frightful colors
as they deserve : young persons addict themselves to
this practice without knowing the enormity of the
crime, and all the consequences which physically
result from it. The mind is affected by all the dis-
eases of the body, but particularly by those arising
from this cause. The most dismal melancholy, in-
difference, and aversion to all pleasures, the impos-
sibility to take part in conversation, the . sense of
their own misery, the consciousness of having
brought it upon themselves, the necessity of re-
nouncing the happiness of marriage, all affect them
so much that the}*- renounce the world — blessed if
they escape suicide.'"

The symptoms here given are precisely such as.
are ordinarily seen in cases of self-abuse, but there
are many others, arising secondarily, which have
only been recently ascribed to this cause. Idiocy
and insanity for instance, and that general failing
of all the physical and mental powers, affecting
both the individual and his offspring, which leads
eventually to the extinction of his family and name.
It is only of late that proper attention has been di-
rected to these terrible evils, and that they have been
thought to beat all under our control. Formerly
they were looked upon as mysterious dispensations
of providence, much to be deplored, but only to be
met with patience and' resignation. Many eminent
writers of the present age have distinctly recognised
the influence of self- abuse, in the production of
idiocy, insanity, and constitutional degeneracy, and
have especially urged the necessity of attending to
it when treating those evils. Among other recog-

SEXUAL ABUSES. 331

nitions of this kind I have been particularly struck
with one, a legislative document, in which there is
more wholesome truth told, and more sound reason-
ing advanced, than in almost all the medical treatises
on the subject put together. It is a Report on the
subject of Idiocy, presented to the Massachusetts
Senate, by Dr. S. G. Howe, in February, 1848, in
compliance with a former resolution of that body
directing such a Report to be made. — I am only
surprised that such a document so valuable should
be so little known, and that the Hon. Senators
should not have seen that their duty was to give it
as wide a circulation as possible. The influence
of such a document, from such a source, must have
been very great, and no doubt would accomplish
more good, in the way of prevention, than all their
. asylums and medical treatment could do in the way
of cure. — In time this and similar Reports will be
eagerly sought for, and their great value, to the
public at large, will be universally admitted. I
shall quote from the Report here for the double pur-
pose of corroborating by it my own statements, and
also of making it more generally known.

In speaking upon the necessity that exists for
boldly approaching this subjeet, notwithstanding the
prejudice that many persons feel against doing so,
Dr. H. makes the following forcible and sensible
remarks : —

" There is another vice, a monster so hideous in
mien, so disgusting in feature, altogether so beastly
and loathsome, that, in very shame and cowardice, it
hides its head by day, and vampyre-like, sucks the
very life-blood from its victims by night ; and it
may perhaps commit more direct ravages upon the

332 SEXUAL ABUSES.

strength and reason of those victims than even in-
temperance ; and that vice is

Self- Abuse.

" One would fain be spared the sickening task of
dealing with this disgusting subject ; but, as he who
would exterminate the wild beasts that ravage his
fields, must not fear to enter their dark and noisome
dens, and drag them out of their lair; so he, who
would rid humanity of a pest, must not shrink from
dragging it from its hiding-places, to perish in the
light of day. If men deified him who delivered
Lerna from its hydra, and canonized him who rid
Ireland of its serpents, what should they do for one
who could extirpate this monster-vice ? What is
the ravage of fields, the slaughter of flocks, or even
the poison of serpents, compared with that pollution
of body and soul, that utter extinction of reason,
and that degradation of beings, made in God's
image, to a condition which it would be an insult to
the animals to call beastly, and which is so often
the consequence of excessive indulgence in this
vice ?

" It cannot be that such loathsome wrecks of hu-
manity as men and women reduced to drivelling
idiocy by this cause, should be permitted to float
upon the tide of life, without some useful purpose :
and the only one we can conceive, is that of awful
beacons to make others avoid, — as they would es-
chew moral pollution and death, — the course which
leads to such ruin.

" This may seem to be extravagant language, but
there can be no exaggeration, for there can be no
adequate description even, of the horrible condition

SEXUAL ABUSES. 333

to which men and women are reduced by this prac-
tice. There are, among those enumerated in this
Report, some who not long ago were considered
young gentlemen and ladies, but who are now
moping idiots, idiots of the lowest kind ; lost to all
reason, — to all moral sense, — to all shame; idiots
who have but one thought, one wish, one passion. —
and that is, the further indulgence in the habit
which has loosed the silver cord even in their early
youth, which has already wasted, and, as it were,
dissolved the fibrous part of their bodies, and utterly
extinguished their minds.

" In such extreme cases, there is nothing left to
appeal to, absolutely less than there is in the dogs
and horses, — for they may be acted upon by fear
of punishment ; but these poor creatures are beyond
all fear and all hope, and they cumber the earth
a while, living masses of corruption.

" If only such lost and helpless wretches existed,
it would be a duty to cover them charitably with
the veil of concealment, and hide them from the
public eye, as things too hideous to be seen : but,
alas ! they are only the most unfortunate members
of a large class. They have sunk down into the
abvss towards which thousands are tending. The
vice which has shorn these poor creatures of the
fairest attributes of humanity is acting upon others,
in a less degree indeed, but still most injuriously ;
enervating the body, weakening the mind, and pol-
luting the soul.

" A knowledge of the extent to which this vice
prevails, would astonish and shock many. It is in-
deed a pestilence which walketh in darkness, be-
cause, while it saps and weakens all the higher
qualities of the mind, it so strengthens low cunning

334 SEXUAL ABUSES.

and deceit, that the victim goes on in his habit un-
suspected, until he is arrested by some one whose
practised eye reads his sin in the very means which
he takes to conceal it — or until all sense of shame
is forever lost in the night of idiocy, with which his
day so early closes.

" Many a child who confides every thing else to
a loving parent, conceals this practice in its inner-
most heart. The sons or daughters who dutifully,
conscientiously, and religiously confess themselves
to father, mother, or priest, on every other subject,
never allude to this. Nay, they strive to cheat and
deceive by false appearances ; for, as against this
darling sin, — duty, conscience, and religion, are all
nothing. They even think to cheat God, or cheat
themselves into the belief that He who is of purer
eyes than to behold iniquity can still regard their
sin with favor.

" Many a fond parent looks with wondering anxi-
ety upon the puny frame, the feeble purpose, the
fitful humors of a dear child, and, after trying all
other remedies to restore him to vigor of body and
vigor of mind, goes journeying about from place to
place, hoping to leave the offending cause behind,
while the victim hugs the disgusting serpent closely to
his bosom, and conceals it carefully in his vestment.

"The evils which this sinful habit works in a
direct and positive manner are not so appreciable,
perhaps, as that which it effects in an indirect and
negative way. For one victim which it leads down
to the depths of idiocy, there are scores and hundreds
whom it makes shamefaced, languid, irresolute, and
inefficient for any high purpose of life. In this
way, the evil to individuals and to the community
is very great.

SEXUAL ABUSES. 335

" It behooves every parent, especially those whose
children (of either sex) are obliged to board and
sleep with other children, whether in boarding-
schools, boarding-houses, or elsewhere, to have a
constant and watchful eye over them with a view to
this insidious and pernicious habit. The symptoms
of it are easily learned, and, if once seen, should
be immediately noticed.

" Nothing is more false than the common doctrine
of delicacy and reserve in the treatment of this habit.
All hints, all indirect advice, all attempts to cure it
by creating diversions, will generally do nothing
but increase the cunning with Which it is concealed.
The way is, to throw aside all reserve ; to charge
the offence directly home ; to show up its disgust-
ing nature and hideous consequences in glowing
colors ; to apply the cautery seething hot, and press
it in to the very quick, unsparingly and unceasingly.

" Much good has been done, of late years, by the
publication of cheap books upon this subject. They
should be put into the hands of all youth suspected
of the vice. They should be forced to attend to
the subject. There should be no squeamishness
about it.

" There need be no fear of weakening virtue by
letting it look upon such hideous deformity as this
vice presents. Virtue is not salt or sugar to be
softened by such exposure ; but the crystal or dia-
mond that repels all foulness from its surface. Ac-
quaintance with such a vice as this, — such acquaint-
ance, that is, as is gained by having it held up
before the eyes in all its ugliness, can only serve to
make it detested and avoided.

" Were this the place to show the utter fallacy
of the notion' that harm is done by talking or writing

336 SEXUAL ABUSES.

to the young about this vice, it could probably be
done by argument, certainly by the relation of
pretty extensive experience. This experience has
shown that, in ninety-nine cases in a hundred, the
existence of the vice was known to the young, but
not known in its true deformity ; and that, in the
hundredth, the repulsive character in which it was
first presented, made it certain that no further
acquaintance with it would be sought."

This is speaking to the point, and Dr. Howe
never rendered more important service to suffering
humanity than when he laid down these momen-
tous truths.

In another part of the Report the effects of igno-
rance are made terribly apparent, not only upon the
unfortunate victim, but also upon society at large,
and it is plainly shown what danger every one runs
while that ignorance exists.

" In some families which are degraded by
drunkenness and vice, there is a degree of combined
ignorance and depravity, which digraces humanity.
It is not wonderful that feeble-minded children are
born in such families ; or, being born, that many
of them become idiotic. Out of this class domestics
are sometimes taken by those in better circum-
stances, and they make their employers feel the
consequences of suffering ignorance and vice to exist
in the community. There are cases recorded in
the appendix, where servant-women, who had the
charge of little girls, deliberately taught them
habits of self-abuse, in order that they might ex-
haust themselves, and go to sleep quiety ! This has
happened in private houses as well as in the

SEXUAL ABUSES. 337

almshouses ; and such little girls have become
idiotic !'

" The mind instinctively recoils from giving cre-
dit to such atrocious guilt; nevertheless, it is there
with all its hideous consequences ; and no hiding
of our eyes, no wearing of rose-colored spectacles,
— nothing but looking at it in its naked deformity,
will ever enable men to cure it. There is no
cordon sanitaire for vice ; we cannot put it into
quarantine, nor shut it up in a hospital ; if we allow
its existence in our neighborhood, it poisons the very
air which our children breathe."

These remarks apply also to our public schools,
in most of which this vice prevails to an alarming
extent, and sometimes in the most open manner. I
have been myself amazed at the revelations made
to me on this subject, both by teachers and pupils,
and clearly enough has it been proved, to my satis-
faction, how that shunning of the subject, which
many so systematically practise, leads directly to
the production and continuance of the vice.

In some few cases masturbation is learned acciden-
tally, or a knowledge of it arises spontaneously, but
in a vast majority of instances it is taught, and
hence the great importance of preventing, if pos-
sible, those who are addicted to it from contamnating
those who are innocent. Dr. Howe remarks :

" There is one remarkable and valuable fact to
be learned respecting this vice, from observation of
idiots, and that is, that some of them, though they
have no idea of right and wrong, no sense of shame,
and no moral restraint, are nevertheless entirely
free from it. They could never have .been in the

29

338 SEXUAL ABUSES.

practice of it, else they would never have aban-
doned it.

" From this may be inferred, that it is a pest ge-
nerally engendered by too intimate association of
persons of the same sex ; that it is handed from one
to another like contagion ; and that those who are
not exposed to the contagion are not likely to con-
tract the dreadful habit of it. Hence we see, that
not only propriety and decency, but motives of
prudence, require us to train up all children to
habits of modesty and reserve. Children, as they
approach adolescence, should never be permitted to
sleep together. Indeed, the rule should be, — not
with a view only to preventing this vice, but in
view of many other considerations, — that, after the
infant has left its mother's arms, and become a
child, it should ever after sleep in a bed by itself.
The older children grow, and the nearer they ap-
proach to youth, the more important does this be-
come. Boys even should be taught to shrink sensi-
tively from any unnecessary exposure of person
before each other ; they should be trained to habits
of delicacy and self-respect ; and the capacity
which nature has given to all for becoming truly
modest and refined, should be cultivated to the
utmost. Habits of self-respect, delicacy, and re-
finement, with regard to the person, are powerful
adjuncts to moral virtues ; they need not be confined
to the wealthy and favored classes ; they cost no-
thing ; on the contrary, they are the seeds which
may be had without price, but which ripen into
fruits of enjoyment that no money can buy."

In the present state of society it is almost impos-
sible, unfortunately, to prevent children from being

SEXUAL ABUSES. 339

taught this vice, either practically or by verbal
instruction, and it is, therefore, necessary to guard
them against it by timely information and warning.
Even if he be strictly kept from vicious associates
the child may learn the habit himself, and may sink
and die from it while the parent is glorifying him-
self on the success of his precautions.

In the article on Insanity in Copland's Dic-
tionary of Practical Medicine, the author, in point-
ing out the various causes of that terrible affliction,
speaks in the following terms respecting self-abuse :

" Many, however, of those causes, which thus
affect nervous energy, favor congestion on the brain,
and occasion disease of other vital organs, tending
to disorder the functions of the brain sympathe-
tically. Of these, the most influential are mastur-
bation and libertinism, or sexual excesses, sensuality
in all its forms, and inordinate indulgence 'in the
use of intoxicating substances and stimulants. The
baneful influence of the first of these causes is
very much greater, in both sexes, than is usually
supposed ; and is, I believe, a growing evil, with
the diffusion of luxury, of precocious knowledge,
and of the vices of civilization. It is even more
prevalent in the female than in the male sex ; and
in the former it usually occasions various disorders
connected with the sexual organs— as leucorrhosa,
displacement of the uterus ; difficult, or disordered,
or suppressed, or profuse menstruation ; both regu-
lar and irregular hysteria, catalepsy, ecstasis, ver-
tigo, various states of disordered sensibility, &c,
before it gives rise to mental disorder. In both
sexes, epilepsy often precedes insanity from this
cause ; and either it or general paralysis often com-

340 SEXUAL ABUSES.

plicates the advanced progress of the mental disor.
der, when thus occasioned. Melancholia, the
several grades of dementia, especially imbecility
and monomania, are the more frequent forms of de-
rangement proceeding from a vice which not only
prostrates the physical powers, but also impairs the
intellects, debases the moral affections, and altogether
degrades the individual in the scale of social exis-
tence, even when manifest insanity does not arise
from it."

Some persons think that masturbation produces
only the same effects as natural excess, and in no
greater degree, but this is a great mistake. There
is the same exhaustion of the semen in both cases,
but in self-abuse it is not accompanied by those
natural associations that bring it about in a pleasing
manner, and leave afterwards a feeling of satisfac-
tion. On the contrary it is induced almost wholly
by a powerful exertion of the imagination alone,
aided by manual means that are felt to be inappro-
priate, so that the act itself is but a very imperfect
gratification, and the feelings that follow it' are
rather those of disgust and remorse than of plea-
surable recollection. The facility with which the
habit can be indulged also leads to its frequent
repetition, and as the concurrence of a second party
is not necessary there is nothing to prevent its
growing and becoming fully confirmed. In fact
the individual becomes a slave to a vice that he
himself despises, and which he feels is destroying
him. The mental tortures of remorse, fear, and
self-condemnation are then added to bodily exhaus-
tion, and we need not wonder at the fearful havoc
they produce. The licentious debauchee will often

SEXUAL ABUSES. 341

look back with a species of pride and vain-glory
upon his numerous indulgences, even when he feels
they are killing him, and he may even feel over
again, by recollection, some of his former pleasures,
but for the victim of masturbation there is not even
this small solace. His pleasure is but incomplete
at best, and clouded by dissatisfaction, while the
recollection of it only excites disgust and fearful
apprehensions.

In fact the evil effects of excessive natural in.
dulgence, particularly the mental ones, bear no
comparison, for severity, with those of self-abuse,
"nor are they nearly so numerous and varied. Na-
tural indulgence, it must also be recollected, cannot
be practised so frequently as masturbation, and
consequently it can never cause such extensive
mischief. It is but seldom that natural excesses
cause insanity or idiocy, except secondarily in the
offspring, but solitary vice frequently does so, both.
in the individual and in his children.

In the Massachusetts Report it is stated that 191
of the idiots examined were known to have prac-
tised masturbation, and in 19 of them the habit was
even countenanced by the parents or nurses ! — 116
of this number were males, and 75 females. — In
420 who were born idiots, 102 were addicted to
masturbation, and in 10 cases the idiocy of the
children was " Manifestly attributable to self -abuse
in the parents V These 10 known cases it should
also be recollected justify the conclusion that there
are really many more, though not ascertained, and
make it clear that much of the idiocy found among
children, both mental and moral, is owing to sexual
vice in the parents ! What a fearful fact is this to
contemplate, and how important that it should be

29*

342 SEXUAL ABUSES.

duly weighed, both by the moral reformer and
legislator.

> In the Annual Reports of the Massachusetts State
Lunatic Asylum, are also some valuable statistics,
showing- the connection between masturbation and
insanity. In the Twelfth of these Reports, I find
that the number of cases existing in the Institute
caused by self-abuse is set down at One Hundred
and Thirty-nine, and yet great pleasure is expressed
that the vice has "fewer victims than formerly."
The decrease in the number is attributed, and justly,
too, I have no doubt, if there be a decrease, to " the
information that has been diffused on the subject,
and the warnings that have reached the young
through the various channels of intelligence that
have been opened on this hitherto obscure subject. "
In the Thirteenth Report One Hundred and Forty-
Jive cases are set down as caused by masturbation,
and some very forcible remarks are made on the
subject which I think it will be useful to copy.

" The causes of insanity may be divided into vo-
luntary and involuntary. Of the former, the princi-
pal are intemperance and the secret vice, other causes
may be of this class, such as hazardous speculation,
many religious vagaries, imprudent exposures, and
irregularities. None are so prominent as the two
first named, and none so fully stain the character
with guilt, which even the occurrence of hopeless
disease can hardly wipe away. Intemperance dis-
orders the senses, and induces apoplexy, epilepsy
and palsy. The cases from this cause are about as
favorable for recovery as the majority of others, but
are most sure to return if the habit of intemperance
recurs. The secret vice produces the very worst

SEXUAL ABUSES. 343

form of insanity, because it is so difficult to avoid
the continuance of the cause, and because the ener-
gies of the system are more prostrated by it than by
almost any other cause. Such patients become de-
graded animals, so entirely abandoned to the habit,
that hopeless dementia and drivelling idiocy gene-
rally follow. A few can be influenced to abandon
the practice, and a few others can be cured in spite
of it ; but in almost all cases the disease will be-
come worse, and these dreadful consequences will
ensue.

" The secret vice, though doubtless a frequent
cause of insanity, and of other severe and fatal dis-
eases far more than is generally supposed, is most
operative in preventing recovery from insanity,
arising from this and other causes. It is extensively
and alarmingly the result of an active propensity ex-
cited by disease and unrestrained by reason, moral
influences or self-respect. Many cases of a favora-
ble character progress towards recovery till this
practice is commenced, then the patient becomes
listless, is inclined to lie down or sit in a bent posi-
tion, walks moderately, looks feeble and feels weak
and miserable. His mind loses its energies, its
scope is circumscribed, more and more, till this
beastly indulgence occupies all his thoughts, and
the remnant of all the physical powers are concen-
trated to this single effort of gross and debased ani-
mal nature. Thus the grovelling sensualist lives
often a long life a degraded sufferer, without a
manly thought or a moral feeling worthy of his
nature or his destiny, and finally leaves the world
without the regret of his . friends, a useless, bur-
thensome, loathsome object of abhorrence and
disgust."

344 SEXUAL ABUSES.

In the two Reports, under the head of " Relation
of Cause to Recovery" I find two hundred and se-
venty-one males enumerated, and twenty-one females,
from masturbation and its effects; and of this num-
ber one hundred and ninety-seven males and twenty-
seven females were incurable ! — Only two of the
females it will be observed being curable.

These Reports also throw much valuable light on
the relation between Masturbation, as a cause of
Insanity, and different occupations.

Some persons express fear that if this subject be
generally discussed, and all are informed about it,
that this very publicity will increase the evil, by
exciting an amount of attention that would not other-
wise have been given to it. The fallacy of this
will be evident enough, to all those who are ac-
quainted with the nature and extent of the vice. It
is next to impossible to prevent its being known,
either naturally or from tuition, and, therefore, no
harm can possibly result from proper information
timely given, while on the other hand, numbers un-
doubtedly perish for want of it.

If it, were true that a knowledge of the nature
and consequences of this habit tends to its being
practised, we ought to find it most prevalent amongst
those who have most of that knowledge, and least
so amongst those who have the least of it. The
truth is, however, directly the reverse, as every sen-
sible person would pre-suppose, and as facts indubi-
tably prove. Those who are educated as physi-
cians of course study everything relating to the
sexual system, and are acquainted with all its de-
tails, while mechanics, generally speaking, never
study anything of the kind, because it is not neces-
sary for them to do so. Now, let us see what pro-

SEXUAL ABUSES. 345

portion of the Insane, from both these classes, are
made so by masturbation.

In the Thirteenth Annual Report I find that there
are in the asylum sixty-two shoemakers, of whom
twenty-four were made insane by masturbation,
which shows that of the insanity existing in this
class of the population, who certainly receive but
little of this kind of information, nearly fifty per
cent., or one-half, arises from self-abuse ! — Now
what is the proportion when we refer to the medical
profession ? I can find physicians made insane by
other causes, but neither in that Report, nor in the
one for the preceding year, do I find a single case
of one becoming insane from masturbation ! These
facts, so far from proving what some assert, that an
intimate acquaintance with the physiology of the
sexual system leads to its abuse, prove1 directly the
reverse, and show conclusively that the best in-
formed go trie least astray.

Other facts in the same Report also show that it
is precisely this kind of knowledge that is needed,
and that no other will either lead the thoughts from
it nor fortify against it. Thus among students the
proportion of insane from masturbation is nearly
seventy-jive per cent., there being eighteen from this
cause out of twenty-jive ; the balance of the cases
being two from ill health, two from domestic afflic-
tion, .two. from religion, and one from epilepsy.
Among merchants the proportion is about jifty per
cent. ; among lawyers, about thirty-three per cent. ;
and among clergymen jifty-six per cent. !

The most frequent cause of insanity is set down
as intemperance, but in numerous cases this has
been first produced by masturbation, the patient re-
sorting to alcoholic and other stimulants, merely as

346 SEXUAL ABUSES.

a temporary relief from the exhaustion produced
by this practise. Ill health is also another frequent
cause, and how often this arises from self-abuse is
well known. In short there is no doubt on my
mind, after duly considering all the facts, that soli-
tary vice produces more insanity than all other causes
put together !

Another valuable fact also shown in these reports
is the influence of occupation in leading to solitary
vice. It is proved conclusively that light sedentary
employments very much favor the formation of such
habits, and that on the contrary active out-of-door
occupation has the contrary effect. Thus among
" merchants, printers, students, and shoemakers,"
fifty per cent of the insanity arises from masturba-
tion, and only twelve per cent from intemperance ;
while amorfg carpenters, blacksmiths, and others
who are actively employed, thirty-five per cent of
the insanity arises from intemperance and only thir-
teen per cent from masturbation. Among seamen
again fifty-four per cent of the insanity arises from
intemperance, and only eleven per cent from soli-
tary vice. — These facts should be duly weighed by
parents when choosing employment for their sons.
Many a youth of sanguine temperament, urgently
requiring muscular and mental occupation of the
most varied kind, is condemned to the monotonous
inactivitv of a countinsr-house desk, the distasteful
plodding of an office or some merely intellectual
profession, and in consequence becomes listless,
dogged, and self-debased. In such cases the abun-
dant vital energy, that ought to have been expended
in active exertion, is retained, and, by stimulating
the sexual organs to an unnatural degree, leads to
solitary vice both as a gratification and a relief.

SEXUAL ABUSES. 347

The effects of masturbation most frequently met
with are weakness of the eyes, swelling and sore-
ness of the eyelids, partial deafness, weakness of the
limbs and back, headache, dizziness, flatulence, in-
continence of urine, diarrhoea or obstinate costive-
ness, palpitation of the heart, shortness of breath,
loss of memory, and confusion of judgment, with
melancholy or irritable peevishness. Another effect
also met with in many cases, is a partial loss of the
power of speech or a tendency to stammer and stutter.
This effect I have often observed in persons who
had previously spoken as fluently as any one, and
who could not imagine themselves what the diffi-
culty arose from. Most frequently it is attributed
simply to that loss of self-confidence, and that feel-
ing of shame, which all self-abusers experience, and
no doubt this does make it worse, but still the main
cause of the impediment is a partial paralysis of the
muscles of the throat, brought on by sympathy with
the irritated parts below. Not unfrequently there
is more or less difficulty in swallowing at the same
time, with frequent sighing and gulping, as if there
was wind in the throat. In fact this class of symp-
toms are very similar to those observed in the hys-
teria of females, with which they are, to a great
extent identical, both in nature and origin.

Baldness is also a frequent occurrence to those
who practise masturbation, and so is premature
whitening of the hair.

Palsy and Epilepsy are more frequently the re-
sults of this practise than is usually thought, and
Paralysis is quite commonly so. I have known
many instances of young men becoming tempora-
rily paralytic from excessive self-abuse, and very
recently I was called to see an old man who was

348 SEXUAL ABUSES.

dying from paralysis brought on in this way.
These affections, though severe, need not be won-
dered at when the powerful sympathies of the gen-
erative organs are borne in mind, and when it is
recollected what an exhaustion of the vital power is
caused by their excessive action.

The best way, however, to exhibit the full effects
of this baneful vice is to give a few illustrative
cases, which will not only portray the prominent
symptoms but also indicate the course of -treatment
usually adopted. Some of them are contributed by
M. Lallemand, and others I have selected from my
own note-book.

" M. D , of Philadelphia, of a very robust

constitution, contracted the habit of masturbation
while at school, when only eight years old. The
first effect produced, was a frequent desire to pass
urine, and at twelve years of age this irritability
had become so great, that he was sometimes unable
to retain his urine a quarter of an hour. Before
entering a house he always took care to micturate
several times in rapid succession ; and, notwith-
standing this precaution, he soon experienced re-
newed uneasiness. He felt as though his bladder
was never entirely empty, and the smallest quantity
of urine induced spasmodic contractions. The ir-
ritability of the urinary organs diminished by
degrees after the period of puberty, but never
ceased entirely, notwithstanding the various means
which were employed on different occasions.

" At the age of sixteen, M. D endeavored

to break off his injurious habits by sexual inter-
course, but he found himself completely impotent,
and shame induced him to return to masturbation.

SEXUAL ABUSES. 349

He afterwards made further attempts to correct
himself, but he experienced nocturnal pollutions,
which often made him lose courage. At length,
after many relapses, he succeeded completely,
without observing any further nocturnal emissions.
Still his health, instead of improving, became more
and more impaired. His erections were less fre-
quent, less prolonged, incomplete, and at length,
gradually ceased, together with all venereal desire.

" At the age of twenty-eight, the state of his
urine, its frequent discharge, and the wandering
pains in the perineum and testicles, induced a fear
of calculus ; sounding, however, *only showed a
morbid sensibility of the urethra, especially towards
the neck of the bladder.

" In the beginning of May, 1837, M. D

came to Montpelier, in the following condition : —
much debilitated ; unsteady in his walk ; easily
chilled, and taking cold very quickly ; wandering
pains all over his body ; skin dry ; memory im-
paired ; digestion difficult ; extremities cold ; scro-
tum relaxed, and testicles soft, very sensitive, and
often causing a dull pain, as if they were forcibly
compressed ; the semen (from the account he gave
of the last nocturnal pollutions he had experienced,)
clear, aqueous, and inodorous; seminal emissions
with the last drops of urine, which were clammy,
and passed with difficulty, and excited a sensation
of tickling in the neighborhood of the anus, which
extended to the orifice of the urethra ; he often had
diarrhoea, but, at other times was very costive^ and
his stools were passed with difficulty and pain. He
did not, however, often pass semen while at stool.

" I discovered, several days following, the pre-
sence of semen in M. D 's urine, and cathe-

30

350 SEXUAL ABUSES.

terism showed an excessive irritability of the
urethra, especially in the neighborhood of the pros-
tate, which, on examination, was found slightly en-
larged. Nearly a table- spoonful of blood followed
the withdrawal of the catheter. The circumstances
did not leave the least doubt on my mind as to the
state of the mucous membrane in the vicinity of the
ejaculatory ducts ; and, consequently, I imme-
diately performed cauterization, from the neck of
the bladder, as far as the membraneous portion of

the urethra. Twenty days afterwards, M. D—

left Montpellier for Italy, and when he returned,
three months afterwards, he was completely cured
— no involuntary seminal emissions having after-
wards appeared. His urine was transparent, and
could be retained seven or eight hours without in-
convenience ; its discharge took place without ef-
fort, and was not accompanied by any remarkable
sensation. Lastly, the patient's impotence, which
had been present nearly twelve years, had given
place to a virility previously unknown to him : I
need hardly state that his physical and moral energy
had shared in this regeneration.

" I have often had occasion to notice the connex-
ion that exists between the spermatic and urinary
organs ; and I have shown that there is scarcely a
cause of spermatorrhoea which does not act more or
less on the bladder and kidneys. The cause I am
now investigating affords us numerous examples of
this connexion — of which the case I have just
related, is a remarkable instance — the irritation of
the urinary organs having been developed very ra-
pidly, having shown very marked symptoms, and
having existed alone during several years. The
patient was only eight years of age when he first

SEXUAL ABUSES. 351

became addicted to masturbation ; at this early age
the urinary organs alone possessed activity, and
therefore they alone were able to suffer disturbance
of their functions ; on this account the symptoms
were confined for a long time to the urinary organs.
The character of the symptoms showed that they
arose from a chronic state of inflammation, or from
an acute irritation of the urinary organs, and this
state must have extended also towards the spermatic
organs. Thus the increased secretion of the kid-
neys, and the extreme irritability of the bladder,
would give a very clear idea of what took place in
the spermatic organs at the period of puberty. As
soon as the testicles began to act, they fell under the
same influence as the kidneys ; the seminal vesicles
were in the same condition as the bladder ; in other
words, the semen was secreted in large quantities,
and was retained a very short time in its reservoirs.
Being therefore imperfectly formed, the usual effect
on the erectile tissues produced by its presence, did
not take place, and coitus was impossible at the age
of sixteen. The occurrence of impotence at so
early an age is sufficient to show that diurnal pollu-
tions had already commenced, although the patient
did not discover them for a long time afterwards.
He was still, however, able to practise masturba-
tion ; and this is a circumstance which has great
effect in preventing persons addicted to the vice,
from renouncing their fatal habits. At a later
period, nocturnal pollutions, which occurred after a
few days' care, shook the patient's resolution. This
is a much less serious circumstance than the one
just mentioned, but at the same time much more
common. At length the patient left off his habits,
and his nocturnal pollutions disappeared ; yet the

352 SEXUAL ABUSES.

disorder of his health continued to increase. His
prudence, exercised too late, did not arise from the
strength of his will, but from the weakness of his
genital organs ; the disappearance of his nocturnal
emissions did not arise from the remedial measures
used, but from the increase of his involuntary
diurnal discharges, of which he only became aware
long afterwards. These common errors are the
more dangerous, because medical practitioners are
apt to participate in them. v

" In the case of M. D the irritability of

the canal was very great, and the effect of the
cauterization was correspondingly prompt and de-
cided."

The above case is a highly instructive one, be-
cause it shows both how early the habit of mastur-
bation may be commenced, and also what a general
disturbance of the economy it may lead to. The
following case is also a very important one, and
shows how very readily the symptoms of Sperma-
torrhoea may be thought to indicate other diseases,
and what mistakes may be made in consequence :

" I am indebted for the following remarkable
case to the kindness of Dr. Daniel, of Cette. ' On

the 26th of May, 1836, I was called to F , a

baker, aged twenty-two ; I found him in bed, in the
following condition : — great moral prostration, car-
ried even to a hatred of existence ; prostration of
strength ; anaemia ; lips pale and shrivelled ; re-
markable pallidity ; eyes sunken ; expression of
countenance dull ; great emaciation ; skin hot and
dry ; pulse small ; voice hoarse, and so low that it
was with difficulty a few words could be heard

SEXUAL ABUSES. 353

by approaching the ear ; constant cough, scarcely
permitting an instant's repose ; general wandering
pains, most severe in the loins, and the sides of the
chest ; great irritability of the stomach — vomiting
being excited after taking almost any kind of liquor
or solid food.

" At first I thought that I recognised in this patient
the symptoms of phthisis laryngea, complicated with
chronic gastritis ; but the examination of his chest
and abdomen did not support this opinion. The
epigastric region was not painful on pressure ; the
respiratory murmur was heard all over the chest,
and percussion emitted a healthy sound, except
under the left false ribs, where it was slightly dull,
and the patient felt pain.

" His debility did not permit me to practise ab-
straction of blood ; and indeed, the pleuropneumonia
of the left side did not seem either very extensive
or very acute ; I therefore ordered a large blister to
be applied over the affected spot, and prescribed a
solution of tartar emetic, and a strict diet. The
pain in the side disappeared, and two days after-
wards, the stomach could retain milk and barley-
water. Still nothing explained the patient's ema-
ciation ; his almost total loss of voice, hoarseness,
and constant cough. His parents attributed these
symptoms to hereditary phthisis, and mentioned that
several members of the family had died of that dis-
ease. Minute and repeated examination of F 's

chest, however, assured me that this was not the
case. On the other hand, the symptoms were very
severe, and I could not discover any visceral lesion
sufficient to account for them. In this state of un-
certainty, your views on spermatorrhoea attracted
my attention. I immediately questioned the patient

30*

354 SEXUAL ABUSES.

respecting his past life, and learnt that at the age of
seventeen, he practised masturbation with such fury
that he had frequently passed aqueous semen, mixed
with blood : frightened by these accidents, he had
corrected himself completely. But, after about a
fortnight's abstinence, he noticed that his urine con-
famed a deposit of thick, whitish, flocculent matter.
He never attached any importance to this, although
during four years, he observed it constantly, and
noticed that it was more abundant after he had been
much fatigued in his business. He observed also,
that the last drops of urine were thick and viscid,
and that a small quantity of viscid matter generally
remained at the orifice of the urethra. His bad
symptoms first commenced at this time ; his erec-
tions and desires entirely disappeared ; and, by the
time he had attained the age of twenty-one ; he was
obliged to give up his employment,, and shortly
afterwards, his symptoms becoming aggravated he
was unable to quit his bed.

" I examined his urine, and found it in the condi-
tion he had described ; the deposit contained in it
being about an ounce in quantity. I noticed that
his testicles were soft, and his scrotum flaccid. He
agreed to my proposition of cauterizing the prosta-
tic portion of the urethra, with eagerness, and I
performed it on the following day. The effect of
the cauterization was rapid : the second night after-
wards, the patient slept soundly ; the third day, a
change was observed in his. voice; and erections
occurred during the night. On the fourth day, the
patient was able to get up and take some light food,
which was well digested ; his wandering pains had
disappeared ; and, by the ninth day after the cau-
terization, the patient's strength had returned.

SEXUAL ABUSES. 355

Tonic regimen, and the use of sea-bathing, con-
firmed his restoration.' "

M. Lallemand gives one case especially which I
think it necessary to copy. It strikingly exhibits
that singular tendency, which many of these kind
of patients have, to take up same peculiar notion
regarding themselves or other people, bearing upon
their unfortunate condition. Some suppose that
every body despises or seeks to defraud them, and
others firmly believe that they are doomed to assas-
sination. In short they are fully persuaded that
society generally is in league against them, and that
they are very ill-used persons. The following case
well illustrates this singular hallucination :

"At the beginning of April, 1836, M. Emile

G was sent to consult me, by Dr. Cauviere,

of Marseilles. He was twenty-five years of age,
and had attracted notice from the brilliancy of his
intellect. At twenty-one years of age, he had been
admitted an advocate in a highly-flattering manner.

" He stooped much, and though his bony system
seemed to announce a strong constitution, his limbs
were small, and his muscles soft. His hair was
black and thin, his skin was pale, and his face with-
out expression. His eyes were dull, and constantly
cast down ; his voice weak and husky ; and his
general appearance announced great timidity. His
legs were constantly in motion.

" I learnt that M. G had contracted the

habit of masturbation at school, at twelve years of
age ; and that whilst studying law in Paris, at the
age of nineteen, he found a change in his character
commencing ; this I will describe in his own

356 SEXUAL ABUSES.

words : — : At first I felt a gradually-increasing dis-
gust of every thing, and a constant sense of ennui.
From that period I only saw the dark side of life.
Thoughts of suicide soon afterwards occurred to
me, and this state of mind continued for twelve
months, after which, other ideas took the place of
those respecting suicide. I considered myself a
subject of ridicule, and fancied that the expression
of my countenance, or my manner, excited an in-
sulting gaiety in the persons I met. This notion
each day acquired new strength, and often, when in
the street, or even when at my own house, or in a
room surrounded by my relations and friends, I
fancied I heard insults which were aimed at me. I
think so still. At length as my state became worse,
I thought that every one insulted me, and 7" still
think so. If any one expectorates or blows his nose,
coughs, laughs, or puts his hand or his handker-
chief before his face, in my presence, I experience
the most painful sensation. Sometimes I feel en-
raged, but more frequently a depression of spirits,
ending in involuntary tears. I look at no one, and
my eyes are never fixed on any object. Wrapped
up in my own thoughts, I am indifferent to all ex-
ternal impressions. These signs are evidently
those of imbecility. I admit that I may have had,
and that I may even now have hallucinations, but I
am fully persuaded that these ideas are not without
foundation ; I am convinced that the expression of
my countenance has something strange in it, that
people read in my looks the fears which agitate,
and the ideas which torment me, and that they
laugh at this unhappy weakness of intellect, which
they ought rather to pity.'

" The patient experienced a sense of heaviness

SEXUAL ABUSES. 357

and oppression in his head, and although fatigued
by slight exercise was constantly in motion. Two
years before he consulted me he began to correct
himself by degrees ; and for nine months he had
entirely renounced the practice of masturbation, yet
notwithstanding this, his state daily grew worse.
His digestion was disordered ; he suffered from
obstinate constipation ; and his erections and vene^
real desires had left him for a long time. Yet he
did not mention the last facts in the written state-
ment of his case which he sent me ; they were
minor evils ; one idea alone absorbed him — the con-
viction that he was an object of contempt and ridi-
cule to all who approached him ; this idea was
aggravated by the knowledge of his impotence, and
by shame for the cause which had produced it.

" This patient's urine usually contained an abun-
dant flocculent deposit, resembling a thick decoction
of barley, it decomposed very rapidly, and emitted
a disagreeable smell. After every stool the point
of the glans penis was covered with a clammy
viscid matter, resembling a thick solution of gum.

" These circumstances confirmed me in the idea
that involuntary seminal discharges alone opposed
the patient's recovery. The frequent emission of
his urine ; the sensibility of the spermatic cords, of
the testicles, and especially of the urethral mucous
membrane, and the injected state of the orifice of
the urethra, made me attribute these evacuations to
irritation of the spermatic organs rather than to
their relaxation.

" As, however, the patient refused to submit to.
cauterization, I ordered him iced-milk, mixed with
spa-water, cold lotions, &c. ; but he found himself
much worse after the use of these means : all his

35S SEXUAL ABUSES.

symptoms were aggravated ; and his urine became
thicker, and left a glairy deposit adhering to the bot-
tom of the vessel.

" At length, on the 23d of April, I persuaded M.

G to submit to cauterization, and I performed

it immediately, chiefly on the neck of the bladder
and the prostatic portion of the urethra ; nothing
particular occurred, except that the inflammation of
the urethra, which followed the application, was not
entirely removed for three weeks. This, I believe,
arose, in a great measure, from the severe weather
which prevailed at the time. I ordered two or
three warm baths to be taken in the week, a few
warm injections and demulcent drinks. At the ex-
piration of a month, the patient took pleasure in
going out, and occupied himself with gardening ;
he felt stronger, and took longer walks ; he was
able to employ himself longer without fatigue ; he
also experienced nocturnal emissions, preceded by
erotic dreams and lively sensations. At this he was
at first alarmed, but he gained courage when he saw
that he was not injured by them. I had not seen
him for more than a month, when one day he called
on me quite dispirited, to say that he should never
get well, as he was relapsing into his former habits.
I blamed him, but at the same time I explained
to him that the fact was a proof of his having re-
gained his former virility, of which he should make

more proper use. M. G 's mother came to me

soon after to speak of the propriety of marriage tor
her son, whom she saw exposed to various dangers.
I easily persuaded her, that before deciding on mar-
riage, it would be necessary for him to be firmly
assured, during a considerable period, of his perfect
and decided recovery. M. G had then re-

SEXUAL ABUSES. 359

gained his spirits, his boldness, and his position in
society, and eighteen months afterwards, all his
functions being performed with energy, he married.
Six months after his marriage I heard that his
health had not for a moment been disordered.

if With this patient I received the following con-
sultation from Dr. Esquirol. ' The undersigned
cannot mistake a case of hypochondriasis which has
lasted three years. It is evident that the nervous
affection was produced by the habit of masturbation
to which the patient was addicted from the age of
puberty, and of which he only succeeded in break-
ing himself seven months since. The hypochon-
driasis continues very obstinately as the cause
which produced it acted for a long time, and very
seriously weakened the nervous system. The un-
dersigned attributes the little success attending
medical treatment to the unfavorable weather, to the
indocility of the patient, who lives in seclusion and
in physical and moral torpor, and to the weakness
of his mother, who allows herself to be led away by
the sight of false or exaggerated sufferings. The
means advised are those usually ordered in cases of
hypochondriasis : — Tonics, antispasmodics, leeches
to the anus, purging, change of scene, travelling,
sulphuretted baths, sea-bathing, &c.' Dr. Esquirol
sums up his opinion in concluding, as follows : — l I
must repeat what I have said above : weakened in-
nervation is the cause of the disease, and every
thing which can strengthen the nervous system, will
be useful.' It was clear that masturbation had been
the first cause of the physical and moral derange-
ment, called hypochondriasis ; but the patient had
renounced this vice during nine months, and his
state became worse daily, instead of improving. It

360 SEXUAL ABUSES.

was evident, therefore, that some other cause acted
in keeping up the disorder ; and it was just as evi-
dent that this cause was involuntary diurnal seminal
discharges. It is not necessary for me to show that
masturbation can, acting alone, induce involuntary
discharges, or that the cure was due to cauterization
only, although its effects were not manifest for a
month after the application of the caustic ; but, I
must insist on the pathological condition of the ge-
nital organs exciting these involuntary evacuations,
since they have been too frequently ascribed to a
state of debility or relaxation of the tissues. The
tonics ordered by Esquirol, had produced no benefit ;
I have described the symptoms which led me to
suspect acute irritation of the prostatic portion of the
urethra, and I have shown the injurious effects of
cold lotions, iced-milk, spa- water, &c. It was then,
not by causing contraction of the orifices of the
ejaculatory canals, that the cauterization produced
its benefical effects, but by dispersing the chronic
engorgement of the mucous membrane. The ad-
vantage derived from warm baths, during convales-
cence, corroborates this opinion.

" In M. G 's case a predominating symp-
tom attracted the attention of the practitioners ;
hence they looked on the disease as being hypochon-
driasis, monomania, or hallucination, continuing
after the cessation of its exciting cause, and be-
coming, consequently, an idiopathic affection. I
have, however, shown that all the functions had
been altered more or less ; I should add, that the
digestion was the last to be re-established perfectly.
Such mistakes are very common, and very serious,
and I cannot too strongly impress their importance
on the attention of the profession. Esquirol justly

SEXUAL ABUSES. 361

stated, the hypochondriasis took its origin from
masturbation ; that the nervous system was weak
and excited : but he mistook the cause which kept
up this condition of the brain. When masturbation
has not induced involuntary seminal emissions, re-
covery soon follows, on leaving off the habit which has
destroyed the health ; within a week the patients begin
to experience a notable improvement, and in a very
short time they are hardly recognisable, whatever may
have been the degree of weakness to which they were
reduced. But when Dr. Esquirol wrote his opinion,

seven months had elapsed during which M. G 's

conduct had been irreproachable, and when I saw
him two months later, his state was even worse,
although he had never resumed his former habits.
The symptoms were, however, kept up by involun-
tary diurnal discharges.

" The effects of cauterization were very conclu-
sive, and so soon as its ourative action was felt, the
patient, of his own accord, took various kinds of
exercise, and sought out the different amusements
which had been, in vain, ordered for him previous-
ly ; he entered into society, and did, without being,
pressed, all that he had before refused to do; his
ideas, and his necessities, altered in proportion as
his functions were re-established.

"It is in vain that we say to the so-called hypo-
chondriac,— amuse yourself, employ your mind, go
into society, seek agreeable conversation ; so long
as we have not removed the cause of his disorder,,
he is unable to profit by our counsels. How can we
expect that when a man is fatigued by the least
exercise, he shall occupy himself with walking, or
gardening ? How can we desire him to go into
society, when the simple presence of a woman inti-

31

362 SEXUAL ABUSES.

midates him, and recalls all his former misfortunes ?
How can we expect him to enjoy conversation,
when he loses its thread every moment ? When his
memory leaves him, and he feels his nullity ? We
persuade him to seek amusements and pleasures, but
are they such to him ? Is not the happiness of
others his greatest punishment ? Because he is
unable to follow our advice we accuse him of un-
willingness, and we wish to compel him. Let us
first remove the cause of our patient's disease, and
we shall soon see that his character and conduct
will change, and that he will return to his natural
tastes and habits.

" It is not long, in such cases, before we are em-
barrassed by questions about the propriety of mar-
riage being put to us : this is a matter which is
serious in all its aspects, and on which the least
scrupulous should not pronounce, without having
had sufficient assurance o£ their patient's return to
health. The question of our patient's health is now
not the only one, nor is even his future happiness
alone implicated ; the fate of the innocent being
who is about to be associated with him is the mat-
ter of chief importance, and justice to her demands
•that we do not counsel matrimony, until sufficiently
long proof has been given that our patient's re-
establishment is permanent."

In the above case there is an answer to the ques-
tion, very frequently asked by the victims of self-
abuse, " what chance is there of recovery V In
nearly every case where involuntary emissions
have not occurred a perfect cure and restoration
may be effected; and even after they have com-
menced, providing they have not existed long, nor

SEXUAL ABUSES. 363

been excessive, we may generally say the same, if
the involuntary discharge can be readily checked.
The chance of cure, therefore, gets less and less in
proportion to the duration of the discharge, and to
the difficulty experienced in arresting it. — So long
as the spermatorrhoea continues, no cure can be ex-
pected, but on the contrary the patient must go on
from bad to worse, notwithstanding all that can be
done for him. — Every victim of masturbation, there-
fore, should pause, and, before he calculates the
chances of escaping, ask himself if he may not be
nearer to this incurable stage than he supposes. I
know that many suffer from involuntary losses, un-
seen, to an extent that makes death almost certain,
who nevertheless flatter themselves that they are in
no real danger, simply because they see nothing.

The origin of this vice, so far as we can trace it
is well pointed out by M. Lallemand, whose re-
marks are quoted below —

" Causes of Abuse. — These may be divided into
two classes : — First, causes inherent in man, or
those acting from within ; these may be considered
as predisposing causes ; secondly, external causes,
or those arising from accidental circumstances ;
and these may be considered as exciting causes.

" Internal or Predisposing Causes. — Of the first
class of causes, the most important is undoubtedly
due to the human organization. In the lower ani-
mals the male and female live together, as if there
were no difference of sex, except during the short
rutting season. This period passed, perfect calm
is restored. In the human species, the secretion of
semen constantly goes on, from the time of maturity
until extreme old age • the secretion may indeed be

364 SEXUAL ABUSES.

increased or diminished by excitement or repose of
the organs, but, during this period, it is never en-
tirely suspended as long as the secreting tissues are
healthy. Still, this universal and important fact
has been much neglected : its application is evident.

" The form of the superior extremities in the hu-
man race, also possesses considerable influence in
predisposing to abuse. Many animals are always
fit for fecundation — spermatozoa being found in
them at all seasons. They are, however, unable to
excite seminal emissions without the aid of the fe-
male. Other animals, again, which during the rut-
ting season, show an almost incredible amount of
erotic fury, are still unable, by their own actions,
to cause spermatic discharge ; their' form alone pre-
vents this, for they often attempt it, and a few even
succeed. It is well known with what fury apes are
addicted to masturbation ; the ape being, of all the
lower animals, the nearest to man in form.

" To this original disposition, more perfect in man
than in any other animal, must be added the influ-
ence of pathological causes. I have alread}' spoken
of the irritation caused by ascarides in the rectum,
of the erections they excite, and of the abuses in-
duced by them. We shall see by and by that her-
petic eruptions on the penis and prepuce, may pro-
duce the same effects, and I shall show also, that an
accumulation of sebaceous matter, between the pre-
puce and glans, may have a similar influence. I
must also mention irritation of the cerebellum, as
inducing serious abuses, of which I shall give cases
in their proper place.

" There is even some connexion between the or-
gans of generation and distant diseases ; for Doctor
Desportes has mentioned a kind of angina, which is

SEXUAL ABUSES. 365

frequently preceded by a considerable increase in
the venereal desires, and, consequently, by a dispo-
sition to all kinds of abuses.

" Pulmonary phthisis, also, is often attended by
considerable venereal excitement. It may as well
then, be at once admitted, that causes predisposing
to masturbation exist in the human organization
itself.

" External or Exciting Causes. — Of these, I shall
lay particular stress on such as act before puberty,
because they have, hitherto, attracted very little at-
tention. The most anxious parents believe that
there is no occasion to watch over the actions of
their children with regard to their genital organs,
previously to the epoch of puberty ; and few, even
of our own profession, are led to suspect bad habits
before that period. This is a fatal error, against
which, it is necessary to be on our guard ; nume-
rous causes may give rise to abuses, at a much
earlier period — infancy being hardly exempt from
them. I saw one unfortunate child, which, while
still at the breast, nearly fell a victim to the stupidity
of its nurse. She had remarked, that handling the
genital organs appeased its cries, and induced sleep
more easily than any other means, and she repeated
these manoeuvres, without noticing that the sleep
was preceded by spasmodic movements. These
increased and took on a convulsive character, and
the child was loosing flesh rapidly, and becoming
daily more irritable, when I was consulted. At
first, I attributed the disorder to worms, teething,
&c, but my attention being attracted by certain
signs, I examined the genital organs, and found the
penis erect. I was soon told all, for the nurse had
no idea she was doing wrong. It was necessary to

31*

366 SEXUAL ABUSES.

dismiss her, for her presence alone sufficed to recall
to the child's memory sensations which had already
become a habit. Time and strict watching were
required before these early impressions were en-
tirely effaced. Dr. Deslandes relates two similar
cases, and Professor Halle, in his lectures on hy-
giene, used to mention many such ; Chaussier, too,
told me of several that came under his notice ; and
both these observers believed such cases to be less
rare than they are usually considered. These ma-
noeuvres quiet the children very readily, and nurses
always endeavor to obtain quiet at any sacrifice ;
they have no idea of the consequences of their con-
duct. At a later period, children are exposed to
the same dangers, on the part of the servants hav-
ing charge of them ; and in these cases, it is not of
ignorance that the attendants are to be accused.
Many patients have consulted me, who owed their
disorders to this cause; and in case 61, I have
shown the influence which such early abuse exerts
on after-life. In some children there is a kind of
precocity of sexual instinct, which leads to very
serious results. In these, it often happens that the
sexual instinct arises long before puberty ; such
children manifest an instinctive attraction towards
the female sex, which they show by constantly spying
after their nurses, chambermaids, &c. These freaks
of children are usually laughed at, but if they were
regarded with more attention, it would become evident
that the sexual impulse has been already awakened.
Rousseau, in his confessions, has well described the
influence which early sexual impulse exercised on
his whole life, and I have received numerous confi-
dences of the same nature, which, however, it would
be of no service to relate here. One case, however,

SEXUAL ABUSES. 367

is so remarkable, that an abstract of it may be in-
instructive. M. D , the son of a distinguished

physician, between five and six years of age, was
one day in summer in the room of a dressmaker,
who lived in his family ; this girl, thinking that she
might safely put herself at her ease before such a
child, threw herself on her bed, almost without

clothing. The little D had followed all her

motions, and regarded her figure with a greedy eye.
He approached her on the bed, as if to sleep, but
he soon became so bold in his behavior, that after
having laughed at him for some time, the girl was
obliged to put him out of the room. This girl's
simple imprudence procured such an impression on
the child, that when he consulted me, forty years
afterwards, he had not forgotten a single circum-
stance connected with it.

" The continual occupation of his mind by lasci-
vious ideas, did not produce any immediate effect,
but about the age of eight, the most insignificant
occurrence served to turn his recollections to his
destruction. Having mounted one day on one of
the moveable frames which are used for brushing
coats, he slid down the stem which supports the
transverse bar, and the friction occasioned caused
him to experience an agreeable sensation in his
genital organs. He hastened to remount, and to
slide down in the same manner, until the repetition
of these frictions produced effects which he had
been far from anticipating. This discovery, added
to the ideas constantly before him, gave rise to the
most extraordinary abuses, and, after a time, to ex-
cessive masturbation.

" I need not mention all the miseries which fol-
lowed this fatal passion ; it will be sufficient for me

368 SEXUAL ABUSES.

to relate the means to which he had recourse for its
correction. He slept on a very hard bed without a
shirt, in order to avoid all friction, and covered by
a single coverlet sustained by a cradle : his arms
were raised, and crossed above his head ; a servant
remained by his side during the night, with orders
to awake him if he changed his position. When
he got up, he put on, next his skin, a shirt of mail
weighing twenty-two pounds, resembling those worn
by the knights of old, except that it had no sleeves,
and that it was attached, at its lower extremity, to a
silver basin, fitted to receive the genital organs, and
provided with openings for the thighs. This shirt
of mail was open in front, in order to be easily put
on and taken off; and when on, it was laced up with
a steel chain, a padlock being attached to the end, the
key of which was kept by the servant, who had or-
ders not to give it up on any pretence whatsoever.
Guarded by the silver basin, the genital organs were
completely removed from the touch, a little opening
only, being left for the discharge of the urine. As
a still greater precaution, the patient had caused
four sharp points to be fixed in front of this case, in
order directly to oppose any erection. This appa-
ratus he continued to wear for nine or ten years,
although it frequently caused inflammation of the
testicles and spermatic cords, by its pressure. Not-
withstanding all these precautions, the patient's mo-
ral and physical condition were deplorable, which
led me to suspect the presence of diurnal pollutions.
" I should observe, that in all the cases of which
I have just spoken, the children were five or ^six
years of age — at most eight — that they did not show
signs of puberty for several years afterwards, and
that they were not exposed to the influence of bad

SEXUAL ABUSES. 369

example. *Their sexual ideas were, therefore, spon-
taneously developed, several years before the deve-
lopment of the genital organs. The same preco-
city is often observed in children of the other sex.
Of this I shall treat more fully hereafter ; at pre-
sent, I shall merely call attention to the case related
by Parent Du Chatelet, of a little girl, who, from
the age of four years, gave herself up to the most
unbridled abuses.

" From these facts, an important scientific conclu-
sion may be adduced : — viz., that in many children
the genital instinct shows itself with much energy,
many years before the age of puberty.

" A no less important practical precaution pre-
sents itself: — viz., that the age of puberty should
not be waited for, in order to surround children with
prudent circumspection, and to prevent their curio-
sity from being gratified.

"Many parents are remarkably careless on the
latter point ; they permit children of both sexes to
play together, promiscuously, for hours, without any
surveillance, provided that they are removed from
all danger of accident, and that their noise is not
annoying. The confidence of many parents, also,
in the ignorance of their children, makes them care-
less of the marks of familiarity which are given to
each other in their presence ; children's sleep is not
always so real or so sound as it seems.

" It is sufficient to point out these facts : every
person can deduce the conclusions ; and now I has-
ten to consider a question, the gravity of which has
been allowed by all who have written respecting
masturbation — I mean the influence of example in
educational establishments.

"If I may judge from my own observations, out

370 SEXUAL ABUSES.

of ten persons whose health has been deranged im-
mediately or remotely from the effects of masturba-
tion, nine first contracted the habit at school. All
that I have read on the subject has led me to con-
clude that this proportion is not exaggerated. A
child brought up in the bosom of his family, is, it is
true, surrounded by many causes sufficient to arouse
his curiosity and excite his imagination ; but such
causes act accidentally, and in an isolated manner
—they only produce a serious effect on a few ardent
imaginations ; a thousand circumstances may re-
move the attention from them. At school it is ad-
mitted that such causes do not exist, but there are
others, less numerous and less varied, but which
operate in a much more active and continuous man-
ner ; the effects of these are direct, and almost ine-
vitable. The child finds, on his first arrival, a focus
of contagion, which soon spreads itself around him ;
the vice is established endemically, and is transmit-
ted from the old pupils to those newly arriving. If
a few privileged individuals escape being initiated,
they are only such as do not experience any gratifi-
cation. But their time will come at a later period;
when the passions make themselves felt, the same
circumstances will be presented to the mind, under
a less disgusting aspect. I shall not enter into de-
tails on this subject ; but from all that has come to
my knowledge, from various and direct sources of
information, I do not hesitate to affirm, that no where
are obscene books circulated more freely and boldly,
than in educational establishments ; that the origin
of the vice is not solely in the scholars, but also in
the ushers and servants, that the abuses are not
always confined to masturbation ; and that they are
not always propagated by example or persuasion,

SEXUAL ABUSES. 371

but are sometimes enforced by threats and violence.
Let it not be thought that I am now speaking of rare
and exceptional cases, or that I exaggerate ;.* I pos-
sess multiplied and convincing proofs of my asser-
tions. I would not either, that I should be misun-
derstood. I am far from denying the advantages of
education in a public school ; and I am ready to
admit that the competition among a number of chil-
dren produces emulation, forms the future charac-
ter, early shows each his own value, and lays the
foundation of friendships which endure through life."]"
"A too sedentary life is injurious at all ages, es-
pecially in childhood, when there exists such con-
stant desire for exercise and change. Gymnastics,
therefore, should, on this account alone, occupy an
important position in the system of education ; but
they must be viewed under a much more serious

" * M. Lallemand of course speaks of the colleges and
private schools in France. I regret to say that his state-
ments apply with nearly the whole of their force to the
schools of England. Vice is common in them, neglect of
physical education and the contracted nature of the stud-
ies to which pupils are confined in our classical seminaries
— the understanding being unappealed to, and the reason-
ing faculties unexercised — the natural sciences neglected,
and the whole of the pupil's life until the age of seventeen
employed in the study of the dead languages — are matters
of vital importance to which society has only recently
begun to direct its attention. [H. J. McD.]

" f M. Lallemand enters very fully on the subject of
education as conducted in France, and well exposes the
errors of the system. Most of his remarks apply to our
own educational system, yet, as the subject is not strictly
medical, and as moreover, M. Lallemand has treated it at
considerable length, I think it best to refer those of my
readers who may wish information on it to the original
work. Vol. I., page 425. [H. J. McD.]"

372 SEXUAL ABUSES.

aspect. Nothing can prevent the genital organs, at
the time of their development, from reacting on the
economy, and giving rise to new sensations and
ideas. It is impossible to prevent the attention from
being attracted by the impressions caused by these
organs ; impossible to restrain the imagination, and
to prevent it from frequently dwelling on such im-
pressions. The slightest circumstance may, in
such a case, lead to a fatal discovery, even if the
information be not transmitted directly, and en-
forced by example. How are such discoveries to
be prevented, or rather, how are their results to be
guarded against 1 Study gives us no aid here ;
indeed, the continued sitting necessary heats the
organs already too excited. The eyes may be fixed
on the book, the ears may appear to listen to the
master, but who can guard against the wandering
of the imagination ? At night it is still worse : no
surveillance can prevent this. There exists only
one means capable of counteracting it, and that is,
muscular exercise carried so far as to induce fatigue.
This alone is able to deaden the susceptibility of the
newly acting organs which excite the economy ;
exercise alone, by requiring matter for the repair
of the muscular waste it causes, withdraws a stimu-
lus from the genital organs, and induces sound and
refreshing sleep.

" Varieties of Abuse. — I think it will be useful
for me to give a few details, respecting the different
kinds of abuse which have come under my notice,
and of which I have seen the hurtful influence on
the genital organs. I shall omit all such remarks
as have not a strictly practical bearing.

" We have already seen the dangers to which
compression of the urethra, to prevent the discharge

SEXUAL ABUSES. 373

of semen during ejaculation, may give rise (case
thirty-five.) In the case I have related, it seems
likely that a rupture took place in the mucous
membrane, because the patient felt, at the instant,
an acute pain, and the following day a discharge
commenced, which continued until the application
of the nitrate of silver. Soon after the commence-
ment of the discharge, involuntary seminal emis-
sions occurred, attended with serious symptoms. It
was immediately behind the glans that this patient
compressed the urethra, and it is quite conceivable
that the sudden and violent distention of the canal
might cause a tear in the mucous membrane. But
this is not always the case ; one of my patients
writes as follows : — ' At the age of fourteen, I prac-
tised masturbation three or four times a week, and
sometimes frequently during the day. In order to
prevent the discharge of semen, I compressed the
root of the penis firmly. Nothing escaped at the
time, but I soon observed that the semen was dis-
charged with my urine, the first time I passed it.
I followed this practice for about two years.'

" Diurnal pollutions soon appeared, and grew more
and more serious. The remainder of the case presents
nothing which is not met with in all cases of sper-
matorrhoea. What I wish to call attention to here,
is, that the compression was made close to the ori-
fice of the ejaculatory ducts, and that the patient
thought at first that his manoeuvres were not fol-
lowed by any loss of semen, although he at length
discovered the contrary. Fournier and Begin re-
port a similar case. It was that of a young man,
who, at the moment of ejaculation, compressed the
most remote parts of the urethra, so that not a sin-
gle drop of semen could escape. Yet the result

32

374 SEXUAL ABUSES.

was the same as in ordinary cases. Notwithstand-
ing his precautions, his strength diminished, and his
disorder made just as rapid progress as if the semi-
nal emission had been perfect.

" The following is even a more remarkable case.
I shall allow the patient to speak for himself. ' I
am thirty-two years of age, and I have had noctur-
nal pollutions from the age of fourteen ; I have also
suffered from discharges while at stool, for ten
years. The cause of these pollutions cannot be
referred to masturbation, for I have not practised it
twenty times during my whole life. The pollutions
are rather owing to reading obscene books, for they
commenced soon after. At first, ejaculation was
preceded by dreams, and accompanied by active
erections and acute sensations, the semen being eja-
culated with force. I tried various means to pre-
vent these discharges. I have slept, during whole
nights, with my penis dipped in cold water, or com-
pressed between two pieces of wood formed for the
purpose. I have tried to keep myself awake in
order to prevent an emission, because, when I suc-
ceeded, the following day I felt stronger, but after
two or three nights, sleep always overpowered me ;
I often awoke, however, in sufficient time to prevent
the catastrophe of my dreams, but frequently it was
too late ; on such occasions, to delay the discharge
or to render it less copious, I compressed the base
of the penis firmly ; but it seems that these com-
pressions greatly injured the parts, without prevent,
ing or diminishing the discharge, which took place
inwardly, as I have often been convinced by in-
specting my urine. From that period the pollutions
have no longer been preceded by dreams ; and the
sensations have left me, so that I am not now

SEXUAL ABUSES. 375

aroused from sleep. My erections diminished, and
have even, latterly, ceased entirely. For three
years erections have rarely accompanied the emis-
sions ; when they do occur I am always less
fatigued.

" There is one thing which I have not been able
to understand, and which will, without doubt, appear
absurd to you ; it is, that I experience pollutions
without erection, sensation, or the escape of semen
by the urethra. I believe that the discharge passes
in a retrograde direction, and becomes mixed with
urine, because, the next morning, I find little glob-
ules, a cloud and filaments in that fluid, just as when
I formerly prevented ejaculation by compressing
the root of the penis ; whilst my urine contains
nothing during the day, or the next morning when
I have not experienced these pollutions. On
waking, I am perfectly aware of what has oc-
curred, by the sweat that covers my face, the fa-
tigue I feel in all my limbs, the headache and diz-
ziness that affect me, the dark circles that surround
my eyes,-&c. I have tried cold and iced applica-
tions, with slight benefit. For some time the pollu-
tions were rarer, and were accompanied with
erection and sensation ; but soon they became as
before, and emission did not take place outwardly.
These internal pollutions have always been the most
weakening. Whenever I succeed in passing the
night without sleep, my urine is transparent in the
morning, and I feel strong. After several nights
without sleep, I generally have an energetic emis-
sion, which fatigues me little ; but soon those with-
out erection and without external discharge return,
and then I always feel worn out on waking.'

" This patient's medical attendant would not be-

376 SEXUAL ABUSES.

lieve in the possibility of pollutions without external
discharge ; but it seems clear that the patient really
had internal emissions without perceptible dis-
charge ; that is to say, that the semen passed into
the bladder, and was discharged with the urine as
had occurred before when ejaculation was prevented
by pressure on the perineum. This compression
was made in front of the ejaculatory canals, and
was very often repeated. It seems, therefore, likely
that it was the frequent repetition of these manoeu-
vres that, at length, caused the spontaneous passage
of the semen into the bladder. But this is a ques.
tion.to which I shall have occasion to return.

" Yet all these manoeuvres scarcely differ from
the various means recommended by some surgeons
for preventing nocturnal pollutions ; and we may
thus perceive how little confidence is to be placed in
the instruments invented for that purpose, and the
inconveniences to which they may give rise. It
seems likely that the dangers would be nearly the
same, in whatever part of the penis the compression
is made ; except that if there be sufficient space in
the urethra, between the point compressed and the
ejaculatory ducts, to contain all the semen, it would
be discharged directly the compression is removed.
When, on the other hand, the compression is made
immediately in front of the orifice of the ejaculatory
ducts, the semen flows back, at least in a great mea-
sure ; so as to induce the patient to believe that the
discharge has been stopped, or at all events, in a
great measure diminished, and to induce a degree
of security which leads to further abuses.

" But to return to the description of the abuses
which have been admitted to me by so many other
patients.

SEXUAL ABUSES. 377

"One of these informed me, that aoout the period
of puberty, while hanging one day by his arm, he
experienced an energetic erection accompanied with
pleasure, and that by his efforts to raise his body,
he caused an abundant seminal emission. This
was the first. The next day he repeated the same
motions, and noticed the same phenomena, and from
that time he knew no other pleasure. From the
principles which had been early instilled into him,
he would have thought himself degraded by con-
nexion with a female, or by the least manual con-
tact with his genital organs; but his conscience was
quiet with regard to these practices, because they
had not been forbidden him. He continued, there-
fore, to hang by the hands, from the furniture,
doors, &c, without being suspected by any one,
and fell, by degrees, into a state of debility and
wasting, equal to those caused by the most unbridled
masturbation. After a time, from weakness, the
patient lost the power of hanging, and his voluntary
emissions ceased ; but they were soon replaced by
nocturnal emissions, which were very difficult of
cure.

" The following are a few passages from a letter
I have recently received. ' Being of an ardent
temperament, I abused myself, from the age of
eight years, by practising masturbation, or rather,
by still more hurtful manoeuvres. By compressing
the penis between my legs, or against the seat on
which I was sitting, I produced excitement, which
was commonly followed by the discharge of a few
drops of viscid and transparent fluid. This prac-
tice I repeated several times a day, up to the age of
sixteen, when I ceased entirely, having been fright-
ened by the discharge of nearly pure blood, which

32*

37S SEXUAL ABUSES.

occurred several times. From this time I only
sought natural enjoyments, but I found it impossible
to obtain a complete erection. This state was attri-
buted to weakness, and was combatted by tonics,
stimulants, and even irritants of all kinds, which
have done me much injury. I used also, cold bath-
ing and cold lotions.'

" I have seen an officer of high rank who had
fallen into the same condition, from the practice of
similar manoeuvres. He experienced his first sen-
sation against the leg of a table, at the early age of
ten years, and continued for several years to em-
ploy the same means. I have already related the
case o£ another child, who allowed himself to slide
down a wooden pole, and the deplorable influence
which this circumstance exercised on the remainder
of his life.

" In a few of my patients, horse exercise caused
the first seminal emissions. I shall relate, by and
by, the case of one of these who knew scarcely any
other pleasure, and who became quite impotent at
the age when virility is generally greatest. The
extreme susceptibility which the genital organs ma-
nifest at the period of puberty, should prevent horse
exercise from being commenced about this period,
as is usually done. It should he begun a few years
earlier, or a few years later.

" I have already spoken of the danger of allowing
children to sleep on the abdomen, (see case thirty-
three) I should add, that many of my patients thus
contracted habits which ruined their health. In-
dependently of the inconveniences to respiration,
digestion, &c, which arise in this position, erections
are favored. The least friction awakens new sen-
sations, and once on the track, progress is soon

SEXUAL ABUSES. 379

made. Sometimes recollections have caused the
choice of this position ; of this I have related a
remarkable example, (see case thirty-four) at other
times, scruples early instilled by a sage foresight,
but which the violence of the impulse has at length
succeeded in eluding, have induced it. Thus, I
have been told respecting one of my patients, that
he would suffer death rather than defile himself by
touching the genital organs, yet, for five or six
years, he seldom passed a night without working
his own destruction while lying on his abdomen.
It is not necessary for me to enter into a description
of the other means by which patients have sought
to satisfy their genital impulses, without transgress-
ing the religious and moral principles which had
been taught them from infancy. Suffice it to say,
that if they have succeeded in satisfying their con-
sciences, they have not succeeded in preserving
their health.

" But to abstain from all direct action on the
genital organs, is not always sufficient to preserve
the patient from serious disorders. A purely
nervous excitement, awakened by other senses, or
directly produced by erotic ideas, may bring the
same results as the worst abuses if prolonged, or re-
peated erections are caused by it. The following
are a few such examples :

" A student, aged twenty-two, born in Switzer-
land, of sanguine temperament, and great muscular
power, fell into the most complete state of impotence,
after having been for some time exposed to ungrati-
fied excitement. He had never practised any soli-
tary vice ; but violent and prolonged erections came
on, and were produced during the day by the influ-
ence of the memory. These erections caused

380 SEXUAL ABUSES.

abundant and frequent nocturnal pollutions. Ab-
sence put an end to the excitement. The nocturnal
pollutions diminished by degrees, and at length
ceased entirely. Yet this patient fell into the same
state of impotence as if he had committed the
greatest excesses in masturbation, and at the same
time preserved the appearance of health and
strength. The cause of his impotence was evident
on examining his urine, and causing him to watch
for diurnal pollutions while at stool, but the cure of
these pollutions was only perfect after two years'
treatment.

" I have seen another case of the same kind, in a
young man who passed from a state of habitual
priapism to one of absolute impotence, without any
other cause than violent excitement of the genital
organs by an ardent attachment; he had never
given way to excess of any kind. I shall record
by-and-by another case of the same kind. I also
had under my care an English officer, who left
Calcutta in perfect health and arrived in London
completely impotent, after having suffered during
two months from almost constant excitement, caused
by the presence of a female on board ship. This
state so opposed to that which had preceded it, con-
tinued for two years — the whole of this time not
being marked by the least sign of virility. It is
scarcely necessary to add, that this state was pro-
duced by diurnal pollutions.

" I related a case a few pages back, in which
nocturnal pollutions were caused by reading an
obscene book ; and I have seen a multitude of
cases of this nature. From these I conclude, that
in certain very excitable individuals, reading such
works, the. sight of voluptuous images, lascivious

SEXUAL ABUSES. 381

conversation, in a word, all things that can excite
or keep up irritation in the spermatic organs are
capable of producing the same effects as actual
abuse, even when the will is sufficiently powerful
to prevent the thoughts from leading to the acts.
On the other hand, an abundant secretion of semen
with importunate erections, irritation of the urethra
and prostate always results under such circum-
stances ; and these favor the occurrence of noctur-
nal and diurnal pollutions as serious, and perhaps
more difficult of cure than those produced by mas-
turbation, because it is impossible to act directly on
the memory or the imagination.

" It is not sufficient then to prevent all material
action on the genital organs ; it is necessary also to
prevent all erotic excitement of the senses and all
concentration of the ideas on lascivious objects.
Fortune's favors are so distributed that numbers
live in absolute indolence without being blamed by
the world, because they demand nothing of any one.
This inaction produces results, the only remedy for
which that I am aware of, is daily fatigue of the
body by various kinds of exercise.

" Effects of Abuses. — The effects produced by
the different kinds of abuse of which I have been
treating, vary according to the age of the patient,
his idiosyncrasy and the different organs chiefly
affected. I. have laid particular stress on the causes
which may lead to bad habits some time before pu-
berty ; I must now consider their effects during
this period.

" The symptoms arising from masturbation in the
the child have been always hitherto confounded
with those produced in the adult; they present cer-
tain distinctive characters, however, which require

382 SEXUAL ABUSES.

our consideration. However young they may be,
children lose flesh, and become pale, irritable,
morose and passionate ; their sleep is short, dis-
turbed, and broken. They fall into a state of
marasmus, and at length die, if not prevented from
pursuing their course. Examples of such a termi-
nation are so well known that I forbear to quote
them.

" Analogous symptoms are shown in the adult —
follow nearly the same course — and may lead to the
same termination ; but in infancy more or less
severe nervous symptoms are superadded, which are
not found in those who commenced the practice
after puberty, or which at least are not in the latter
case manifested to the same extent. Such are
spasms and partial or general convulsions, eclamp-
sia, epilepsy, and paralysis, accompanied with con-
traction of the limbs ; these phenomena were present
in all the children whose cases I have noticed, and
numerous similar facts have been published by dif-
ferent authors.

" Contractions of the limbs have been well inves-
tigated by Dr. Guersten, and he notices that they
especially affect such children as are lank, un-
healthy-looking, nervous and worn out by bad habits.

" The following case is sufficiently remarkable.
In 1824 a woman brought her son, aged eight to the
hospital St. Eloi : he had lost the use of his lower
extremities for some months. The limbs were fixed,
drawn together, and all the muscles contracted.
The child was extremely thin and his intellect was
much disturbed. Masturbation, the cause of all
these disorders, had only been discovered by his
mother a few weeks before she placed him under
my care, but she had used every means she could

SEXUAL ABUSES. 383

devise to prevent it without effect. After two or
three trials I found that it was of no use trusting to
the strait-waistcoats and other means usually em-
ployed, and accordingly I determined to pass a
gum-elastic catheter into the bladder, and to fix it
so that the patient should be unable to withdraw it.
The presence of the foreign body, excited inflam-
mation of the urethra as I expected ; when this
occurred, I withdrew the instrument, but replaced
it as soon as the inflammation had subsided. I kept
up, in this manner, a constant state of inflammation
for a fortnight, which rendered the parts so painful
that the child was unable to touch them. This
treatment produced more decisive success than I
had ventured to hope ; within eight days the lower
extremities had regained sufficient strength and mo-
bility to allow the child to get up, and in another
fortnight he was able to run about the wards. I
then sent him away threatening him with a return
of the same treatment if he relapsed. The pain
caused by the catheter seemed to have removed all
the other impressions, for his health continued good,
and growth followed its ordinary course.

"I have since employed the same means in many
cases, with just as much success, and I think it
more sure than any other, because it is impossible
to rely on the patient's will, or on the assiduity of
those who are appointed to watch over him. In
children, too, it leaves an impression on the memory
which is often sufficient to destroy the empire of
habit, and to prevent a return to the former ma-
noeuvres.

. " But to resume the consideration of the symp-
toms observed in children. In childhood, seminal
emissions are never experienced, but nevertheless

384 SEXUAL ABUSES.

the patients fall into a state of marasmus, to which
some even succumb. These effects, like those ob-
served under the same circumstances in the female,
have induced some authors to leave out of their
consideration the seminal discharges which are pro-
duced by the same acts at a later period. They
have attributed the debility which follows all abun-
dant discharges of semen, to the nervous excitement
and convulsive motions, which usually accompany
the discharge. The accidents observed before pu-
berty are evidently only due to the effects on the
nervous system ; and, the same sensation accom-
panying voluntary emissions after puberty, it is
natural to suppose that the nervous system plays as
active part then, as in childhood. I willingly admit
the importance of this nervous exhaustion in what-
ever manner it may be supposed to operate ; and
supposing, even that its action on the economy is
just as important as during childhood, (which is not
the case, as I shall presently show,) this is no rea-
son why the actual discharges should not be taken
into account, seeing that they greatly modify the cha-
racter and consequences of the nervous disturbance.
" I have already noticed that the symptoms pro-
duced by abuses during childhood present a spas-
modic character ; this character, without doubt, is
derived from the predominance of the nervous sys-
tem at that period, rendering children so alive to
external impressions. This excessive sensibility
also explains the great disorder of the economy
which children suffer from such manoeuvres. Des-
landes relates a case, showing that any action of
the same kind may produce the same effects at
this early age. He says, ' An observer worthy of
credit, Dr. Nurambeteu, has communicated to me

SEXUAL ABUSES. 385

the case of a child who procured himself similar
sensations by drawing out the navel. His health
became much disordered from the effects of this
strange habit, which had such a power over him
that coercive measures were required for its correc-
tion. It is worthy of remark that this patient
showed neither erection, nor any other phenomenon
of the generative organs, which at all referred to
sexual intercourse.' The organs of generation
therefore, had no influence in producing the sensa-
tions experienced by this child ; but the repeated
titillation of a very sensitive part produced the same
disorder as masturbation.

"It was proved in the debates on a recent crimi-
nal trial that death may be caused by prolonged
tickling of the sole of the foot. Nervous disorder,
arising from such proceedings, may then be carried
so far as to cause death, and from this may be ima-
gined the effects of the multiplied convulsive shocks
which irritable children produce, by acting on the
most sensitive organs in the economy.

" Every excessive loss of semen also, even when
unaccompanied by sensation, is followed by debility,
and this may be carried so far as to cause death ; I
have related several such cases in the beginning of
this work.

" There exist then two distinct causes ; nervous
disturbance and debilitating discharges, and both
these act at once, when seminal emissions are pro-
duced by the influence of the will. It is not to be
wondered at, that both these causes should produce
nearly the same symptoms, because they both
weaken the economy. The action of the first on
the nervous system is direct and immediate, and the
symptoms that result from h are of a more spasmo-

33

386 SEXUAL ABUSES.

die character. It is very easy to confound these
two causes when they act simultaneously ; but I
have just shown that they can be considered sepa-
rately. The following reason shows the import-
ance of so doing.

" Whenever we succeed in entirely putting a
stop to the habits of abuse in children, we may
make sure of obtaining their return to health, and
that very quickly. This I have remarked in all
the cases of children that have come under my
care. I do not mean to infer that the disorder done
to nutrition during the progress of development is
easily repaired, but that the acute symptoms rapidly
disappear, and that all the functions are quickly re-
established. If the effects produced are active and
serious they cease very rapidly, as soon as the
cause is removed, and return to health becomes cer-
tain. Unfortunately matters do not follow so sim-
ple a course after puberty.

" What I have just said respecting children, ap-
plies equally to females ; this is easily shown by
examining the cases in which excision of the clito-
ris has been performed for the cure of nymphoma-
nia. The state of these unfortunates must have
been deplorable indeed, to justify the resort to such
means ; yet they recovered very rapidly.

" Why in these two classes of cases, is the cure
certain and the return to health rapid, as soon as
the vice has been mastered ? It is that the cause
of the weakness immediately ceases to act on the
economy. Why is it that so many men continue to
waste away after they have entirely left off their
habits of abuse ? It is because diurnal pollutions
have commenced, which are even more debilitating
than the abuses which gave rise to them.

SEXUAL ABUSES. 387

t( Dr. Deslandes and many others have discovered
that there is a great difference in the conditions of
persons who have practised masturbation for some
time, and then renounced it : but they have not
sought the explanation of this fact. It is, how.
ever, very important to know why some are cured
rapidly and completely, while others continue to
suffer and languish during the remainder of their
lives. The symptoms experienced by the latter are
those produced by diurnal pollutions.

" But if we inquire why some should be affected by
diurnal pollutions while others are exempt, we dis-
cover that we have been comparing two very diffe-
rent classes of patients. The one class conquered
their bad habits by the force of their will ; the other
class were compelled to renounce them by impo-
tence. The former resisted their desires while they
were yet active ; they required much perseverance
and moral energy in order to succeed ; the latter
only left off as they were less tempted — the pro-
gressive decrease in their erections being due to the
presence of undiscovered diurnal pollutions.

" Such patients deceive themselves as to the cause
'of their changing their habits, and are astonished at
not finding any benefit arise from such change.
Some of them even remark to their medical attend-
ants that it is after they have left off their mal-
practices, that their health has become altered.

" All these circumstances, embarrassing at first
sight, are easily explained on a little reflection. At
first the genital organs are healthy ; the constitution
is uninjured ; no seminal emissions occur except
those that are induced voluntarily ; and the activ-
ity of the digestive organs permits a rapid repair
of the losses. But as soon as irritation is set up in

388 SEXUAL ABUSES.

the spermatic organs, a large quantity of semen is
secreted and escapes every day, and several times
a day without the patient's knowledge ; the diges-
tion is disordered ; the erections and voluptuous
sensations diminish, because the semen is less per-
fectly formed ; the provocatives are, therefore,
weakened by degrees, and the patient renounces
without difficulty, habits which only inspire him
with disgust. He wonders that his health still con-
tinues to grow worse, for he has not discovered that
he passes daily, by often repeated evacuations, more
semen than he formerly passed in a perceptible
manner, and he does not take into account the diffi-
culty felt by his economy of repairing these fre-
quent discharges.

" We must not then confound those, whose viri-
lity leaves them, with those whom the power of
their will causes to recover, and we must not be
surprised at seeing the alteration in the habits of
each followed by very different consequences.

" In order to make the distinctive characters of
these two positions clear, I have laid stress on their
most striking points, but there are numerous slight
shades of distinction, which I have not mentioned."
For instance, in some cases the two classes of phe-
nomenon occur successively in a very distinct man-
ner, at very near periods. Many patients having
corrected themselves once, find their health promptly
re-established. But when, after recovering their
strength, they have relapsed into their former ha-
bits, on renouncing them a second time they obtain
no benefit. These different results under appa-
rently similar circumstances can only be explained
by the occurrence of diurnal pollutions in conse-
quence of the return to habits of abuse.

SEXUAL ABUSES. 389

" Case thirty-one is a clear and perfect proof of
the correctness of this explanation ; the patient re-
covered twice after having twice conquered his pas-
sion, but the third time he only gave it up through
disgust, and his health continued to deteriorate until
cauterization arrested the diurnal pollutions from
which he suffered.

" There are many circumstances which interfere
with the good resolutions of those addicted to mas-
turbation, After a few days of absolute continence,
attained with much difficulty, they frequently suffer
from nocturnal pollutions, the more frequent and
the more abundant in proportion as the spermatic
organs have been much irritated : the patients al-
ways feel more debilitated by these involuntary dis-
charges, than by those which they previously ex-
cited. Instead of combating these pollutions by
suitable means, or after having employed one or
two plans unsuccessfully, they think they will be
able to diminish the evil by recurring to their former
habits at distant intervals, and they thus relapse,
increasing still more the irritation of the parts.
Soon after diurnal pollutions commence, and rapidly
produce their effects, but as these are not discovered,
the patients rejoice to find the nocturnal discharges
gradually disappearing. But their health daily
grows worse ; this they cannot comprehend, and are
frequently led to imagine that they have mistaken
the cause of their disorder."

33*

390

CHAPTER XII.

EROTOMANIA AND SATYRIASIS.

These two affections are usually confounded
together, but there is considerable difference in
their nature, though their manifestations are similar.
In both of them there is an unnatural excitation of
sexual desire, so that it sometimes becomes utterly
uncontrollable, and gratification is sought at any
cost. In these cases there is a real furor, or mad-
ness, which arises from disease, and is not a mere
moral aberration, as uninformed people suppose.

Satyriasis arises from a disease of the sexual
organs or of some of the adjoining parts, which
keeps them in a constant state of irritation, some-
times so great that the patient cannot obtain the
slightest relief, either sleeping or awake, but is kept
the whole time in a state of furious excitement.

The diseases that are most likely to produce
Satyriasis are those of the urethra and prostate
gland, though sometimes gravel, or even the piles
will originate it. Dr. Curling remarks that " The
irritation attending the morbid condition of the
mucous membrane of the prostatic portions of the
urethra, tends, in a very material degree, to excite
both the excessive seminal discharge and the secre-
tions of the prostate, and to produce that morbid
craving for indulgence and abuse, which persons
who have brought themselves to this state find so
difficult to repress and resist. It is well known
that any irritation at the orific of an excretory duct

MORAL DERANGEMENTS. 391

usually acts as a stimulus to the secretion of the
gland. Thus hurtful matter in the duodenum pro-
duces a flow of bile ; and a foreign body in the con-
junctiva, as an inverted eyelash, a discharge of
tears. So it is with the Testes, when irritation ex-
ists at the Orifices of their excretory ducts. The
disorder at this part, moreover, appears to react on
the brain, and to become in part the cause of the
patient's mind being constantly occupied with sub-
jects of sexual excitement, and of his indifference
and apathy to other matters. So that the local dis-
ease induced by abuse powerfully aids in perpetu-
ating the mischief, and, judging from the experience
which I have had in these cases, is the object to
which our treatment should be first directed.

In many of these cases it is of no use reasoning
with the patient, and telling him to control himself,
unless the exciting disease be also corrected ; it
would in short be of little more use than telling him
he must not give way to a diarrhcea or any other
morbid action. In a note in Dr. Curling's work
this truth is well laid down, and applied to a class
of cases for which usually no excuse is thought to
exist. The writer says, " This is a truth, I fear,
not sufficiently impressed on the minds of medical
men. One would be loath to offer any apology for
the vicious habits and indulgences to which, it is
well known, old men are occasionally addicted, — a
melancholy example of the kind, in the higher ranks
of life, having lately been brought under public no-
tice. I cannot but think, however, that, in many
instances, these cases are not undeserving of profes-
sional sympathy, and that the erotic longings which
sometimes continue to distress the aged, long after
the period at which, in the course of nature, they

392 MORAL DERANGEMENTS.

should have ceased, depend as much on physical in-
firmity as mental depravity, the former inciting and
producing the morbid desires. If these propensities
were regarded and treated as symptoms of disease,
(and that they frequently occur in connexion with
affections of the urinary passage is well known to
practical surgeons), I believe they would often sub-
side, and the distressing results to which they lead
would be altogether avoided."

The same remarks also apply to every other pe-
riod of life, and especially to youth, as every physi-
cian of experience in such matters must be well
aware. I know that, in numerous instances, the
sexual feelings of young persons are preternaturally
excited by local disease, and that their genital
organs are thus kept in a state of excitement by
causes over which they have no control. This fact
should be kept always in view when considering
such cases, and we should recollect that a medical
prescription may often accomplish reform, when a
moral precept has failed, of which the foregoing
Chapters of this work will furnish many illustrations.

I was once consulted by a married man, the father
of a family, whose habits had always been strictly
moral and proper, but who suddenly found himself
subject to occasional fits of the most intense sexual
excitement, over which he had but little control.
So completely was he the slave of his morbid feel-
ings, in fact, that it was with the greatest difficulty
he kept himself from the most disgraceful and licen-
tious indulgence. He had latterly shut himself up
alone when one of these fits came on, and was at
other times in constant fear that he should sometime
or other ruin his reputation for ever, even if he did
nothing more serious. The condition of this man

MORAL DERANGEMENTS. 393

was truly pitiable, subject as he was to a state of
misery for which, if it were known, he would re-
ceive condemnation instead of sympathy. " Every
one would tell me," he remarked, with tears in his
eyes, " that it was disgraceful, and that I ought not
to give way to it, but I cannot help it though it were to
save my life, and I have sent for you because I think
you must understand my true position." — I found
on examination that this gentleman was affected
with a chronic inflammation of the prostate gland,
and lower part of the urethra, which was liable,
from various slight causes, to become temporarily
worse, and to produce that excitation of the genitals
above described. He distinctly remembered that
before each of the fits he had either taken some se-
vere exercise, or been subject to some unusual men-
tal agitation or perhaps had committed some error
in drink or diet, which seemed to bring it on. But
of late the parts had become so extremely sensitive
that the simplest excitement, of any kind, brought
on an attack, and it was scarcely possible for him to
avoid one long together.

I immediately informed him of the cause of his
trouble, and as it was not the result of abuse of any
kind, and apparently not unusually severe, I felt
justified in promising him relief, and immediately
put him under proper treatment. — The diet and
drink were rigidly regulated, bathing and regular
exercise enjoined, and a tonic of Iron and Gentian
administered. I also found it necessary to use the
caustic internally, and to advise astringent lotions,
with occasional injections to keep the bowels free.
Under this treatment the irritation soon began to
subside, and in two months he had no return of his
erotic fits. — Now if this man had committed some

394 MORAL DERANGEMENTS.

gross immorality during one of these periods of ex-
citement, it would have been considered merely as
the result of moral depravity, and nothing would
have been thought of but punishment, instead of me-
dical treatment. — It is unfortunately true that moral
depravity is often the only cause of such improper
actions, and then they ought to be visited accord-
ingly ; my object here is not to apologize for any-
thing of that kind, but simply to show that there are
often other cases, of a totally different character,
which should be considered in a different light.

Satyriasis is very apt to follow from the first at-
tempt at masturbation and from excessive indulg-
ence, particularly in those who use stimulating food
or drink. — I have also known tobacco and opium to
bring on an atttack, and still more frequently cer-
tain medicines when improperly used, such as can-
tharides and phosphorus.

Erotomania differs from Satyriasis as respects the
seat of the disease, which in this case is in the brain,
and not in the genitals, they being affected only se-
condarily. It is in fact a species of mania or insa-
nity in which the mind is constantly occupied with
sexual matters, and a constant morbid desire is ex-
perienced for indulgence, sometimes even when the
patient is completely impotent. Dr. Copeland draws
the distinction between the two diseases very clearly,
and I will, therefore, quote his words, merely re-
marking that 'Nymphomania, to which he refers, is
merely the same disease in the female as Satyriasis
in the male: —

" Erotomania — Monomanie erotique of Esqjjirol
— is characterized by an excessive love of some object,
real or imaginary. — It is a mental affection in which

MORAL DERANGEMENTS. 395

amorous ideas are as fixed and dominant, as reli-
gious ideas are in religious monomania or melan-
cholia. Erotomania is very different from satyria-
sis and nymphomania. In the latter, the mischief is
in the reproductive organs ; in the former, it is in
the mind. The one is a physical, the other a moral
disorder. Erotomania is the result of an excited
imagination, unrestrained by the powers of the under-
standing ; satyriasis and nymphomania proceed from
the local irritation of the sexual organs, reacting
upon the brain, and exciting the passions beyond the
restraints of reason. In the former, there is neither
indecency nor the want of chastity ; in the latter,
there is unrestrained expression of sexual desire
and excitement. The one is commonly caused by
ungratified or disappointed affection excited in a
virtuous mind ; the other, by inordinate irritation or
indulgence of the sexual passion.

" In erotomania, the eyes are bright, the manner
and expressions tender and passionate, and the ac-
tions free,, without passing the limits of decency.
Self and selfish interests are all forgotten' in the
devotion paid, often in secret, to the object of the
mind's adoration. A state of ecstasy often occurs
in the contemplation of the perfections which the
imagination attaches to the subject of its admira-
tion. The bodily functions languish during this
state of moral disorder; the countenance becomes
pale and depressed ; the features shrunk ; the body
emaciated ; the temper inquiet and irritable ; and
the mind agitated and despairing. The ideas con-
tinually revert to the loved and desired object; and
opposition or endeavors to turn them in a different
direction only render them more concentrated and
determined in their devotion. At last, parents and

396 MORAL DERANGEMENTS.

fortune are abandoned, social ties broken asunder,
and the most painful difficulties are encountered in
order to obtain the object of admiration.

" In some cases, the attempts made by the patient
to conceal and overcome this affection occasion a
state of irritative fever, with sadness, depression,
loss of appetite, emaciation, &c, which has not in-
appropriately been termed by Lorry Erotic Fever,
and which, after continuing an indeterminate period,
may even terminate fatally. When a young per-
son becomes sad, absent in mind, pale and emaciated,
sighs frequently, sheds tears without any obvious
reason, is incapable of mental or bodily exertion,
scarcely speaks to any one, loses appetite, &c, it is
sufficient^ evident that the mind is inordinately
possessed by some desired object. If a strong effort
be not made to dispossess it of the predominant sen-
timent, or if the object of desire be not obtained, the
symptoms become still more distressing. The cor-
poreal functions languish, the eyes sink, the pulse
becomes weak and irregular, and the nights dis-
turbed and sleepless. At last a form of slow hectic
is produced ; and the weaker organs, especially the
lungs and heart, are the seat of slowly-produced
disease ; the whole frame is blighted, and the pa-
tient sinks from the injurious influence of the men-
tal affection on the vital organs.

" This form of moral disorder may increase, and
affect the intellects in a much more serious manner,
until general insanity or mania is developed ; and,
with the progress of time, it may at last terminate
in dementia or incoherent insanity. In each of
these, the primary character of the disorder, or the
original moral affection, will still continue to be
manifested by ther frequent suggestion of the same

MORAL DERANGEMENTS. 397

train of ideas, or recurrence to the object of
devotion."

The treatment of these cases requires great skill
and experience on the part of the physician, and
frequently a continued observation for a long time,
in order to determine what the*exciting cause really
is. It may be wholly moral or wholly physical, or
it may be partly both, and this must be ascertained
before any good can be accomplished. The fact is
philosophy is required as much as physiology, and
the most perfect confidence must exist between the
physician and the patient. The affections have
often much to do with these peculiar troubles, and
it should not be forgotten that there is a great differ-
ence in the temperaments of different persons, and
also in the sensitiveness or impressibility of their na-
tures.— Those who wish to study the philosophy of
this curious subject in relation to the other sex,
should read the articles on Hysteria and Chlorosis in
my "Diseases of Woman." Some persons always
recommend marriage in these cases, to single per-
sons, and there is no doubt but it is sometimes what
is required, but at other times it is highly improper.
In certain forms of physical derangement especially,
marriage would only aggravate the evil, and the
patient would in all probability ultimately become
totally unfit for the married state. This advice,
therefore, if followed, would not only fail of doing
any good to persons so situated, but would make
two unhappy instead of one. — It will be seen that
some forms of Erotomania are identical with what
is called, commonly, Love Sickness.

Again, I remark, that in all such cases goodjudg-
w.ent is required equally with skill.

34

398

CHAPTER XL

GENERAL REMARKS ON THE PRESERVATION AND
RESTORATION OF THE SEXUAL POWERS.

This Chapter is intended to embrace all those
items of information, and those interesting facts not
directly needed in any of the previous articles, but
which nevertheless it is useful to know. Some of
these are moral, some medical, and some physiologi-
cal, and the whole of them will be found highly
suggestive, as well as directly instructive. It is pre-
cisely this kind of information that is very fre-
quently most needed, but hitherto there has been no
source, except dear-bought experience, from which
it could be obtained. The grand object of medical
science should be to prevent disease, if possible,
rather than attempt to cure it, and such knowledge
is an important agent in prevention.

It is unfortunately the case, as our previous arti-
cles have shown, that the sexual power is liable to
be impaired, or even totally lost, from a variety of
causes, and that it is exceedingly difficult of restora-
tion. There are, however, many apparently simple
rules which, if duly observed, would prevent much
of the injury now experienced, and there are also
many others equally simple which will often mate-
rially assist in its restoration. The object of this
Chapter is to point out many of these, chiefly in the
form of suggestions and hints ; the strictly medical
treatment having been fully entered into already.

It is very essential to the preservation of the

GENERAL REMARKS. 399

sexual power that the general health should be
good, and that there should be no serious derange-
ments of any of the vital functions. When the
general health is impaired and the vital energies
are low, the sexual organs are sure to be weakened,
and usually more in proportion than any of the
others. Owing to their extensive sympathies also
they are sure to be affected by the diseases of all
the other organs, and not unfrequently this sympa-
thetic injury becomes very serious. The stomach
particularly exerts a great influence over the gene-
rative organs, both beneficial and injurious. Long-
continued dyspepsia is nearly always accompanied
by weakened sexual power and desire, and even
temporary attacks of indigestion will, for a time,
produce similar effects. On the other hand a
healthy stomach, with perfect digestion and nutri-
tion, is highly conducive to sexual vigor. We may
even go much further, and show that high feeding
is nearly sure to over-excite the genital organs, or
in other words that gluttony leads to licentiousness.
This is a truth too often lost sight of in the education
of children, many of whom, though predisposed to
sexual ardor, are stimulated with rich food and ex-
citing drinks till their passions become overpower-
ingly strong. — In short the stomach exerts a most
decided sympathetic influence over the generative
organs, and we are thus enabled, by proper atten-
tion to the diet and drink, to either increase or
weaken their power to a great extent.

Some kinds of food stimulate the sexual organs
while other kinds have the contrary effect upon
them. Shell-fish, as before stated, are usually sti-
mulating, owing to the phosphorus they contain, but
other fish have no such power. Flesh-meat is sti-

400 GENERAL' REMARKS.

mulating merely because it is nutritious, but it is a
great mistake to suppose that it is of necessity more
so than vegetables. There are some vegetables
that are often more stimulating than flesh, especially
those that are farinaceous or contain much starch,
as the potato for instance, which, when of good
quality, contains most of the elements the body needs.
Most strong tasted or aromatic vegetables have a
stimulant effect, such as Celery, Parsnips, Onions,
and Asparagus, especially, and so have all season-
ing herbs, such as Mint, Sage, Pennyroyal, and
Thyme. Spices and condiments have a still stronger
action, especially the Peppers and Nutmeg. — Mush-
rooms stimulate some people very much, and Truf-
fles still more, and even Olives exert a marked in-
fluence at times. The flesh of birds I think is not
stimulating, except that which is red, such as ducks
and geese. I have several times been assured that
eating freely of the Canvass-back duck, when' in
season, has been highly beneficial to those who were
weakened by excess, probably partly from its own
nature and partly from the wild Celery on which it
feeds. Of all meats, however, Turtle has the great-
est reputation for exciting the generative organs,
and I think with good reason. It is undoubtedly
highly nutritious, and it appears also to contain
some heating principle, which specially affects those
parts.

As a general rule all watery vegetables, such as
turnips, cabbage, and squash, have no such effect
as those enumerated, and are therefor proper when
we wish to keep down excitement. Acid fruits
also come under the same category, and indeed
fruits generally, except some highly-flavored ones,
such as peaches, and pine-apples which are un-

GENERAL REMARKS. 401

doubtedly aphrodisiac, except they disagree with
the stomach.

Tomatoes are rather stimulating, and so are most
kinds of beans, especially the Lima Beans, but
peas are not so. Wheaten bread or wheaten flour
in any form, is more stimulating than the flour of
any other grain, while Indian meal is probably the
least so. When we desire an anaphrodisiac effect
therefore, Indian bread should be used, with mush,
samp or hominy, instead of wheaten bread or pota-
toes. Rice is unstimulating, but sago, tapioca, and
arrow-root are the reverse.

In regard to drinks it mav be stated that all alco-
holic liquors are highly stimulating when first taken,
but they soon lose their power if used too long or
intemperately, and then they become injurious.
Wine has a more strengthening effect than spirits
of any kind, and ale or porter is still better than
wine. Those who desire to keep their passions
down should not take either wine or malt liquor in
any quantity. — Most of the cordials in use are highly
exciting owing to the spices they contain, and so
are many of the so-called bitters. — Coffee is almost
as stimulating as wine, and should never be used
by those who are disposed to involuntary emissions,
nor by those whose desires are too strong. Tea is
different from coffee in this respect, and is therefore
the better drink in such cases. Milk, though highly
nutritious, is not stimulating, and it therefore forms
an excellent drink for those who are disposed to
emissions or exciting dreams ; such persons, how-
ever, will do better to use cold water only, and they
should also avoid all warm fluids, no matter how
simple, because warm drinks always excite the flow
of urine, and of course stimulate the sexual organs

34*

402 GENERAL REMARKS.

also. Those who cannot use the cold water only-
may drink soda and mineral waters as much as they
choose, or lemonade if it agrees with them, none of
these being in the least degree exciting.

Next to the stomach, it is important to attend to
the state of the bowels, as they exercise considera-
ble influence over the generative organs, and may
affect them in a very injurious maaner. The bad
effect of piles has already been alluded to, and also
constipation, but this last disability is of more con-
sequence than it has perhaps been represented to
be. No person must expect to escape seminal
weakness who is habitually constipated, no matter
how vigorous and healthy the genital organs them-
selves may appear to be. It is, therefore, very im-
portant, as a means of preserving sexual vigor, that
the bowels should be always properly regulated, and
frequently a little attention to this point is all that rs
needed to complete a vecovery. — The opposite state,
diarrhoea, though of course weakening, is not so
decidedly hurtful as constipation, and its effects are
soon recovered from.

Next to the stomach and bowels the urinary or-
gans may be mentioned as exerting great influence
over the sexual system. The proof of this has
already been given, but I think it necessary to call
attention to the fact here as one of the very first im-
portance. If the kidneys or bladder be affected in
any way the genital organs are sure to be affected
likewise, and if the urine have an irritating quality,
it is nearly certain to act on the urethra and ducts
so as to cause sexual excitement or spermatorrhoea.
This is particularly important in regard to children,
many of whom are disposed to precocious virility
or to masturbation, simply from being affected with

GENERAL REMARKS. 403

gravel or with some disease of the kidney or blad-
der. Those children most liable to such troubles
usually find it difficult to hold their urine during the
night, and it is very high colored, with a strong
odor. Such children are very apt to be subject to
spermatorrhoea in after-life, and also to be addicted
to self-abuse ; it is, therefore, very important that all
such affections of the urinary organs should be
promptly attended to. At every after-period of life
also such matters require serious attention ; for many
a man is kept diseased and impotent by the same
causes, which may operate so powerfully as to neu-
tralize all attempts at cure while they remain. —
When any of these diseases exist, at any period, it
is requisite, of course, that the diet and drink should
be regulated especially in reference to them, the
urinary organs being readily affected by those
agents.

Constant and healthy exercise of the whole mus-
cular system is also of great importance to the pre-
servation of sexual power. It is true that if a man
takes little exertion, particularly if he lives high,
he will be apt to exhibit an unusual tendency to
amorous indulgence, because, as before remarked,
gluttony and idleness lead to licentiousness. This
effect, however, is only a temporary one and sooner
or later the individual finds that he has 'permanently
' exhausted his vital energy and that his health and
strength is seriously impaired. The vital power
that may be safely expended in sexual indulgence
is only the surplus, after every part of the system
has apppop dated its due amount, and if more be so
expended some part must suffer. In other words
we may suppose that every healthy man has a cer-
tain stock of vital energy, which we will call his

404 GENERAL REMARKS.

capital, to which he keeps adding, more or less, by
the function of nutrition ; this addition may be
compared to interest which may be expended with-
out any loss of capital, and of course without mak-
ing him any poorer. If, however, by any excess he
expends more than this addition the capital is pro-
portionably diminished, and permanently too, for it
can seldom he again made up.

Now, the idle man does not expend enough vital
energy on his muscular system to keep it healthy,
but at the same time gives a superabundance of it
to the sexual organs, so that they are over-stimu-
lated, and suffer from excess. They become habi-
tuated to great indulgence, and are constantly caus-
ing a drain on the vital power, that soon exhausts
both principal and interest and leaves the indivi-
dual completely exhausted.

The philosophy of this has been frequently alluded
to in the course of the present work, but it is so im-
portant that I wish to present it in a strong light. I
am fully persuaded that there is no case of preco-
cious or excessive sexual propensity, unless caused
by disease, that cannot be easily subdued by muscu-
lar exercise. No matter how vigorously the semi-
nal glands .may act, in a state of leisure, they must
become less active if the body be exhausted by ac-
tive exertion, and to this rule there is scarcely any
limit. One of the Reports of the Massachusetts
Lunatic Asylum strongly impresses this truth, and
shows conclusively that we have, in hard labor, a
certain means of subduing this propensity to its pro-
per limits under any circumstances. The applica-
tion of this truth to young persons is obvious, num-
bers of whom are made licentious only by bodily
inactivity and over-feeding.

GENERAL REMARKS. 405

The invalid, or the man whose powers are im-
paired must of course husband his strength, because
he does not require exhaustion, but only sufficient
exercise to ensure health.

Exercise of the mind is also equally as important
as exercise of the body. The man who is mentally
idle is nearly certain to experience too strongly the
force of the animal propensities, and licentious
thoughts are too often indulged merely from the
absence of better ones. It must be recollected,
however, that too much mental exertion, particular,
ly if attended with care and anxiety, is most de-
structive to the sexual power, and frequently leads
to impotence, as many of our cases have shown.
Those who wish, therefore, to preserve their virility
should endeavor to maintain a happy medium,
laboring with the mind sufficiently for health and
utility, and endeavoring to preserve perfect calm-
ness and equanimity. This subject was explained
in one of our former chapters on Impotence, and the
remarks there made may be again referred to, in
connection with these, with advantage.

There are many indulgences which people allow
themselves, some of which are apparently very
simple, that exert a decided influence over the
sexual organs, and in time impair their power.
Some of these have been alluded to, particularly the
use of tobacco and other narcotics, but there are
some others also deserving of notice, though of less
consequence. Some persons are much affected by
odors, which operate either as stimulants or as seda-
tives to the nervous system, and sometimes produce
peculiar effects. That there are odors that specially
excite the sexual instinct is beyond question, some
naturally and others artifically, though different

406 GENERAL REMARKS.

people experience their effects in very different de-
grees. There are also others that exert an opposite
influence, though seldom in so decided a manner.
Very sensitive people, particularly those in whom
the sexual instinct is naturally strong, may be as
much excited by a mere scent as by a medicine
conveyed into the stomach, as I have frequently
seen. Hysteria is often excited in this way in
females, as I have shown in my work on the Dis-
eases of Women, and various forms of nervous ex-
citement frequently supervene in the other sex from
the same cause.

It may be stated, as a general rule, that all power-
ful odors may produce effects of this kind, and they
are, therefore, better avoided, particularly the habit-
ual use of them. There are some particular scents
that exhibit this power more constantly, and to a
greater degree than others, and several of these
are articles of common use in the toilette. An
enumeration of these would embrace many of the
choicest perfumes used, but it is scarcely possible to
particularize among so many, nor is it necessary.
as the whole are better avoided. The very origin,
and natural use of some of these indicates clearly
enough the purpose Nature intended them to fulfil,
in the animals from which they are taken, and I
cannot but think that few females at least would use
them if they really knew what they were. Musk,
especially, is an article of this kind, the aphrodisiac
effects of which I have sometimes seen exhibited in
the most unequivocal manner.

The readers of classic poetry will call to mind
the story of the Indian Prince, who exhibited such
marvellous powers merely from smelling the flowers
of the Nympha odorato, and also several other in-

GENERAL REMARKS. 407

stances in which the aphrodisiac power of different
odors is distinctly alluded to, showing that the gene-
ral truth was known centuries ago. Some of these
accounts are of course much exaggerated, but most
of them are founded upon actual truths, as I have in
some cases proved, and I believe the statement about
the Nymplia is one that is entitled to consideration.
Perhaps, however, the most important suggestions,
as regards the preservation of the procreative power,
are those relating to its actual use. It is well
known, respecting all the other vital functions, that
their healthy performance and preservation, depends
materially upon their being exercised at proper
times, and under proper circumstances, and it is the
same with the generative functions. Many persons
think, because the genital organs are usually capa-
ble of action at any time, and under almost any
circumstances, that it is therefore of little conse-
quence what time is chosen, nor under what circum-
stances it may be. This, however, is a great mis-
take, as any one may soon discover by studying his
own experience.

The time for sexual indulgence should be so
chosen that the temporary excitement and after-ex-
haustion resulting from it, may not interfere with
any of the bodily or mental functions, nor distress
the system by necessitating too much effort during
any needful exertion. Ignorance of this important
rule, and consequent neglect of it, very often leads
to great inconvenience, and even serious mischief.
Sexual indulgence just after eating is nearly certain
to be followed by indigestion, even if it does not
cause immediate vomiting, owing to the temporary
loss of nervous power thereby produced, which
arrests the action of the stomach. Just before eating

408 GENERAL REMARKS.

also the same evils may follow, from the stomach
being made so weak that digestion cannot properly
commence, and the food consequently ferments.
Many times I have heard men confirm this truth,
when explained to them, though they had previously
never dreamt that their troubles arose from such a
cause, and when our previous explanations are borne
in mind, respecting the nervous sympathies of the
sexual organs, the philosophy of it will be evident.
The proper time for this indulgence therefore, in
reference to taking food, is at a sufficient interval
after eating for digestion to be nearly accomplished,
and before another meal begins to be needed. By
observing this rule the action of the stomach is not
interfered with, and no indigestion or nausea are
likely to follow. It is true, that most men experience
stronger desire for indulgence immediately after a
full meal, particularly when stimulating drinks have
been used, but this does not prove that they choose
the best time. The desire they then experience is
merely a factitious one, produced by the general
excitement of the whole system, and the exhaustion
afterwards felt is nearly always in proportion. In
the same manner a man, while under excitement from
alcohol, may feel disposed to great bodily activity,
and may exhibit astonishing strength, but when the
stimulus is withdrawn he feels a corresponding pros-
tration and lassitude. This is the reason also why
sexual indulgence should not be sought during such
excitement, for the disposition is nearly sure to be
stronger than natural, and the over-excitement is
followed by proportionate exhaustion. In Poetry, I
am aware, Venus and Bacchus are associated
together, but Poetry is not always Physiology, nor
even common sense, nor should the licentious furor

GENERAL REMARKS. 409

produced by wine be in any way considered as the
promptings of nature.

Upon the same principles it is obviously injudi-
cious to seek indulgence just previous to any mental
effort being made, because the vital energv will be
too much exhausted to allow of such elfort being
made with advantage. Nor is it advisable imme-
diately after any great mental effort, because it is
injurious to have tivo causes of exhaustion in action
at the same time. — The same remarks also apply to
muscular exercise, which should neither immediately
follow nor closely precede sexual indulgence, for
the reasons above given. — In short the period chosen
should be one when both body and mind can enjoy
repose, at least for a short period, both before and
after, and when none of the functions are likely to
be disturbed.

The time of day is a matter of secondary import-
ance or rather no preferable time can be named,
because it must so much depend upon how the indi-
vidual is circumstanced. That of course will be
the best time when the above-mentioned rules can
be most fully observed. Some medical writers sug-
gest the evening, because the business of the day is
then over and the repose of night is to follow, and
this probably is the best period, generally speaking.
Others again recommend the morning, because
there is then the greatest vigor, and in case of con-
ception the offspring may be benefitted thereby.
This, however, I feel assured, is a bad suggestion,
for the business of the day will be very apt to
oppress a man who starts exhausted, and the
various functions of his system will very likely
be imperfectly performed. The notion about the
offspring being influenced at the moment of concep-

35

410 GENERAL REMARKS.

tion, by the state of the male system, I have al-
ready shown the fallacy of, because that moment
may not nearly correspond with the period of
association.

The duration of the sexual power, like any other,
materially depends on the manner in which it is
used, and this should therefore be duly considered
by those who think its preservation worth striving
for. A certain amount of natural indulgence is
probably essential, in most cases, to perfect health,
but when that amount is exceeded of course more
or less permanent injury results, as before shown.
Every individual should, therefore, endeavor to as-
certain, for his own guidance, the proper limits to
his gratification, and if he will attend to what has
been previously stated on this point that limit may
be readily ascertained. By doing this a real gain
will always be made, for the extra duration of the
power which this will ensure will more than com-
pensate for any temporary denial. — With some peo-
ple whose systems are in regular action, and whose
health is nearly uniform, the observance of a regu-
lar period is found to be advantageous, and highly
conducive to the preservation of the virile power, as
it prevents both excess and gradual decline.

These hints and suggestions, though apparently
simple and common-place, are nevertheless of great
value, and if duly observed would probably do
more towards preventing untimely decay than, all
the medical treatment ever practised. Decay is
caused, in numerous instances, by a number of small
causes operating together, and if each of those be
removed, as it may generally be very readily, the
decay is of course prevented. • People are too apt to
take notice only of the more striking agents of de-

GENERAL REMARKS. 411

struction, passing unnoticed these apparently sim-
ple ones, as being of small consequence while in
reality they are the most important.

There are few persons of good health, who will
attend to the above suggestions, and the advice form-
erly given, but what may preserve their powers to
an indefinite period of their existence, particularly
if they practice cold, local bathing over the parts, and
avoid all improper excitement. — There is no parti-
cular time of life when the powers of the male sys-
tem decay, but they may be preserved to extreme
old age, as many cases have proved. — Old Parr for
instance was condemned to do Penance when over
a hundred years old, for an amorous intrigue, and
he had several children after that period.

There are some other circumstances, connected
with the association of the sexes, that exert an im-
portant influence over the duration and manifesta-
tion of the sexual power, but as they do not concern
man alone it is not necessary to enter fully into a
consideration of them here, but merely to point them
out as concerning- both sexes.

o

There is no doubt but that Nature has instituted,
in numerous instances at least, if not universally, a
peculiar fitness, or adaptation between particular
individuals of opposite sexes, that makes them more
appropriate companions to each other, in marriage,
than they can ever be to others. And on the con-
trary, it is equally certain that there is as great an
unfitness in some individuals, so that their union is
in every way objectionable. This adaptation may
be either mental, moral, or physical, or it may be
all three, and sometimes it consists in something we
cannot understand, though its existence is too obvi-
ous to admit of dispute. Nature frequently exhibits

412 GENERAL REMARKS.

wonderful sympathies and antipathies, which we
cannot comprehend, but which should be attended to,
as far as possible, in making our arrangements, for
it is always injurious to run counter to them. There
are many causes of unfitness, and consequent un-
happiness, that could be discovered before marriage,
and many others that could be corrected after, if the
parties possessed a certain amount of physiological
knowledge, but unfortunately such knowledge is
seldom obtained in time, and the consequences must
be experienced. It is not my purpose to discuss
this matter fully here, but merely to show its bear-
ing upon the subject now being discussed. There
is no question but that association between persons
properly adapted to each other is less exhaustive,
and may be more frequently indulged, than between
those who are naturally unfitted to be companions.
And it is also certain that the circumstances under
which the association occurs may very much deter-
mine the effect it will have. It is requisite, for the
act to be truly pleasurable and advantageous, that it
should be fully approved both by the feelings and
the judgment, otherwise it will be more or less re-
gretted, and more or less injury will follow, no mat-
ter what amount of mere animal gratification was
experienced. This is the reason why mere licen-
tious debauchery is always followed by remorse,
and ill health, while legitimate association in mar-
riage, with a loved and respected partner leads to no
such evil results. It is a fact equally important to
individuals and to society at large, that the institu-
tion of marriage is conducive both to health and to
happiness, and that the duration of life, in both
sexes, is longer in that state than in any other. Many
men fall into a great error in regard to this subject,

GENERAL REMARKS. 413

and suppose that they can realize more pleasure in
the unlicensed indulgence of the single state than
when married. This is, however, a fatal mistake,
for they really enjoy less, and are after all dissatis-
fied with themselves, while the duration of their
powers is materially shortened.

Some little time ago I had a very interesting
conversation on this subject with a Swedenborgian,
who remarked that many of the principles laid
down in my lectures exactly corresponded with his
spiritual views on marriage, and that his own expe-
rience fully corroborated the truth of what I had
stated. He told me that in his youth he was unfor-
tunately led into a licentious course of life, and ex-
perienced in consequence all that self-accusation and
loss of real pleasure which I described, but that
since his marriage, and in consequence of the im-
portant truths learned from Swedenborg's writings,
he had subjected his passions to the control of rea-
son, and had led, as he expressed it a new life. He
assured me that, with the partner of his bosom,
association was never followed by exhaustion to
either, but on the contrary by a feeling of increased
strength and pleasure to both, and I have no doubt
but he spoke the literal truth, for I have been fre-
quently told the same by others. He regarded this
as a spiritual effect, while I looked upon it as a
simple physiological one, but be that as it may the
fact is an important one, both as regards health and
morals. These subjects, however, will be fully
discussed in a work on the Reproductive Functions
and Marriage, which I have been for a long time
preparing, and which will be shortly issued. It has
been delayed in order to institute a number of ex-
experiments, and an extended series of observations,

35*

414 GENERAL REMARKS.

to clear up all doubtful points and make the expla-
nation complete.

Another important requisite for the healthy action
and extended duration of the sexual power, in both,
is a near correspondence in age. Experience has
proved beyond doubt that when there is great dispa-
rity of age, in marriage, the elder person is nearly
sure to benefit at the expense of the younger, some-
times even sufficiently to compensate for the loss
resulting from great excess. This fact was acted
upon medically in former times, and is now even in
some countries, by procuring young females to sleep
with old men, so that they may be strengthened
thereby, which they nearly always are, though the
females suffer a corresponding loss, and not unfre-
quently waste and die in consequence. Such un-
natural practises are therefore properly discounte-
nanced now, both by reason and morality, though we
sometimes see a near approach to them in marriage.
It is even known that when children sleep with old
persons they suffer from it, and sometimes even die,
without the causes of their sickness being suspected.
In all probability young men who marry old females
suffer in the same way, and to an equal extent, pro-
viding they are as exclusive in their companionship,
but there are many causes that may make it other-
wise in their case.

What constitutes a great disparity of age must of
course depend upon various circumstances, besides
the number of years. Some persons are younger at
forty or even fifty, in respect to health and probable
longevity, than others are at twenty-five or thirty
and this must be taken into account. Generally
speaking, however, there should not be much more
than ten years difference under any circumstances,

GENERAL REMARKS. 415

and only half that is better, the man being the elder.
— Besides health this principle of similarity of age
has an important bearing upon the relative number
of the sexes born, as shown in my Matron's Manual,
to which I refer those who wish for more extended
information on the subject.

The explanation of the above-mentioned fact is
probably this, — all living bodies are constantly
giving off portions of their substance, in the form
of insensible perspiration, and these particles
thrown off are in the same state, in regard to age
and health or disease, as the body from which they
emanate. The same bodies are also as constantly
absorbing, both by the lungs and by the skin, what-
ever is presented to them in a proper form, which
partly counterbalances the loss. Young healthy
persons are, therefore, always giving off a stream
of fresh wholesome material from their bodies, and
old or diseased persons as constantly give off a
stream of morbid and decaying matter, which ex-
plains why it is that the young suffer and the old
benefit when they live together. The waste of the
old persons is in part made up by absorbing the
fresh exhalation from the young, and they become
thereby rejuvenated, while the waste of the young
persons is only made up by absorbing the decaying
exhalation from the old, and they in consequence
speedily decay and become old likewise. The ce-
lebrated Hufeland, in his " Art of Prolonging Jjife"
gives some curious instances of the practical ap-
plication of this fact which are highly interesting,
in a scientific point of view, though morally repre-
hensible. Among others he tells us of an old man
who had the superintendence of a kind of alms-
house, in which were a large number of young

416 GENERAL REMARKS.

girls, in whose society he passed nearly the whole
of his time. He contrived to have a number of
them always around him, so that he was constantly
in an atmosphere as it were of youthful exhalation,
and by these means he preserved his life to an ex-
treme old age, with all his powers in full vigor. A
similar practice, to a certain extent, has even been
adopted in London and Paris very recently, as was
discovered in the evidence on a Police Trial. It
appeared, from the statements made, that a number
of poor young married females were hired to attend,
at certain establishments, for so many hours in the
day, to associate with superannuated old men. And
not only did these young females associate in com-
pany with the aged patients, but they also supplied
them with what ought to be kept for infantile nutri-
ment alone, — in short they acted as wet nurses to
them ! — The results of the practice were said to be
very satisfactory, but fortunately there is not suffi-
cient degradation and poverty in this country to
make it available here, though I have known it at-
tempted.— With persons of equal age, and similar
condition of health, the exhalations are similar, and
there is an equal loss and gain on both sides. —
During sexual excitement the insensible exhalation
is much increased, and therefore the effects above-
mentioned are more evident where there is associa-
tion, and this perhaps explains, as my Swedenbor-
gian friend remarked, why it is that in a proper
marriage no exhaustion at all is experienced, there
being merely a reciprocal interchange exactly cor-
responding in both.

THE END.

APPENDIX. 417

DR. ROLLICK'S PRIVATE LECTURES.

Dr. H., has long been engaged, as much as
his extensive practice would allow him, in the
delivery of Public Lectures, to Ladies and Gen-
tlemen separately, on the Physiology and Diseases
of the Reproductive System. These Lectures have
been attended by numerous audiences, of both
sexes, in many of the chief cities of the Union, and
have every where received the unqualified appro-
bation of all who have heard them. They are
appropriately illustrated by Anatomical Models and
Plates, of the most complete and costly kind, so
that unprofessional persons can easily comprehend
the explanations given. The object of these Lec-
tures is to give a practical knowledge of those
diseases and imperfections, to which all are liable,
that appertain to the Reproductive System alone, so
that they may be both guarded against, and properly
treated, by all persons for themselves. The un-
fortunate prevalence of these affections, and the
extent to which they influence human health and

418 APPENDIX.

happiness, is well known, and every one who has
reflected upon the subject must see the great utility
of such a popular exposition.

The causes of many of these diseases can be
readily avoided when they are known, or they can
be easily cured in the early stages, but when
allowed to remain too long unchecked they become
utterably incurable. How much more important it
is therefore for the people to be taught how to
prevent, than for physicians only to experiment
with means of cure. It is a great mistake to sup-
pose that a general knowledge of such matters is of
no utility, merely because it is not extensive, for
the smallest amount may often enable a person to
avoid evils that all the skill in the world could not
cure.

Dr. Hollick's Lectures are intended to give this
desirable information, in a familiar and unobjec-
tionable form, so as to be practically useful to every
one. How far they have done so may be judged
by the appended notices.

APPENDIX. 419

Notices of Dr, Hollick's Lectures,

Dr. Hollick and Physiology. — The second of a series of Lectures,
by this gentleman, on human physiology, and the all important truths
connected with our physical constitution, was attended by a full
house, in National Hall, last evening. The time was well spent, and so
appeared to think the audience. On the delivery of the first of these
Lectures on Tuesday evening, the speaker in a comprehensive and
well-digested exordium, placed himself and the subject right with the
public. His-manner, language and style, did the first ; his sound logic,
his argument, his candor and research, accomplished the second.
Apart from the interesting and apposite details of the wonders of repro-
duction, the illustrations of the immutable wisdom of nature, which
teem in the animal and vegetable worlds — which

" Glows in each stem, and blossoms in each tree ;
Lives through all life, extends through all extent,
Spreads undivided, operates unspent."

Apart from all this, Dr. Hollick's Lecture was excellent as a defence
of truth, a vindication of the right of free and unshackled inquiry, and
as a convincing refutation of that silly, but far too prevalent opinion
that there are truths of which it is better to remain in a state of igno-
rance. Had nothing else been imparted in the forcible and well
defined exordium of Dr. Hollick than this judicious demolition of that
fallacious, silly, but injurious twaddle which would forbid research
to pass in advance of the old landmarks prescribed by custom, igno-
rance, or a spurious morality — even that would well deserve the public
patronage. Truths, well set forth, will make an impression, whether
their investigation be fashionable or not. There is an affinity between
the capacity to learn, and the truths to be learned, which always
results, when a fitting opportunity is presented, in a free inquiry, and
the gentleman who is bringing, in a judicious and elevated manner, a
knowledge of those fundamental principles of our corporeal existence
which are abused because unknown, will accomplish more good than
half a dozen teachers of higher pretensions, and lower ability. It was
gratifying to observe the decorum — the sense of respect for both
speaker and subject, that was observed throughout the evening, which
evidently shows that those who go there are actuated by higher
motives than mere curiosity ; by desires more ennobling than a
passing gratification ; in a word, it was clear that those who com-
posed Dr. H.'s hearers, were men who know and dare to think, and
who will profit by these most ussful discourses. — New York Herald,
-August 7, 1844.

420 APPENDIX.

At a Meeting of the Class attendant upon Dr. Hollick's Select
Lectures on the Physiology and Philosophy of the " Origin of Life"
in Plants and Animals, held at the Lecture Room of the Museum,
Wednesday evening. December 1, 1844, George G. West, Esq., was
called to the Chair, and Samuel W. Black appointed Secretary.

Resolved, That we have listened with unfeigned pleasure and
interest to the Courses of Lectures delivered by Dr. Hollick. and now
brought to a close, and that we deem it an act of justice to him and
the community, to express our entire confidence in his character,
ability, and the manner of illustrating his subject, which, to use the
words of a daily journal, "is couched in such delicate as well as per-
spicuous language, that the most fastidious could find no fault, nor the
idlest curiosity go away unimproved."

Resolved. That a committee of three be appointed to tender to Dr.
H. the thanks of the Class for his courtesy to the members in affording
them every facility for obtaining information upon the subject of his
Lectures, and that he be requested to repeat the Course at the earliest
period consistent with his other engagements.

Published in all the Philadelphia daily papers of December 14, 1S44,
and signed by one hundred a?id forty of the most respectable and influ-
ential inhabitants.

(See similar Resolutions, with over two hundred names attached, in
the Philadelphia daily papers of March 9, 1844 ; also of March 16 ;
and on several other occasions.)

From the Philadelphia Daily Papers, Feb. 21, 1845.

At a meeting of the Ladies composing Dr. Hollick's Class, held on
Wednesday afternoon. February 19th, in the Lecture Room of the
Museum, the following resolutions were unanimously adopted, and
ordered to be published in one or more of the city papers :

Resolved, That we have listened with great pleasure and interest to
Dr. Hollick's Lectures, and are happy to add our testimony to the
manj- already recorded in behalf of such Lectures : and legarding Dr.
Hollick as a benefactor of his race, and especially of our sex, we
cordially wish for him abundant success, and ample reward in the
consciousness of doing good.

Resolved. That we will exert ourselves to induce our female friends
and acquaintances to avail themselves of the great and rare privilege
of obtaining the valuable instruction imparted in these Lectures in so
chaste and dignified a manner.

Signed on behalf of the meeting by

Susan Wood, President.
Sarah Wkbb, Secretary.

{fcj=> With over 50 names attached thereto.

(See also similar Resolutions, with numerous names, on Feb. 27,
1846, March 20, 1840, and on Apiil 10, 1846, with over three hundrei
names attached.)

APFENDIX. 421

Dr. Hollick's Lectures. — The third and last course of Lectures
by Dr. Hollick, will commence this evening in the Franklin Saloon,
corner of Baltimore and North streets. This will positively be the
last course during his present visit to this city. We cordially say to
those who love a scientific treat not to fail to attend. Wore instruction
is contained in those three Lectures, than can be mastered by a twelve
month's reading. — Baltimore Clipper, March 30, 1847.

From the U. S. Gazette, Phila., Feb. 18, 1845.

Dr. Hollick. — The first of a course of three Lectures was given by
this gentleman last night, in the' Lecture Room of the Philadelphia
Museum, and it is scarcely necessary to say, was listened to by a
large audience with the deepest interest. The doctor not only
reasons philosophically, but has the happy faculty of imparting infor-
mation in an easy and plain manner, so that it may be comprehended
by even those not at all conversant with medical science.

Dr. Hollick's Lectures. — Last evening Dr. Hollick delivered
another of his Lectures on the " Origin of Life." These Lectures
continue to attract much attention, and are commended by all who
tear them. During the past week Dr. H. has given a private Lecture
and exhibition of his models to many of our prominent Senators and
public men, all of whom expressed themselves highly gratified, and
desirous that another class should be formed to accommodate their
friends who had not attended. — National Intelligencer, Jan. 30, 1846.

Dr. Hollick's Second Lecture was delivered last Wednesday
night at Concert Hall. The Lecture was well attended by many dis-
tinguished gentlemen, among whom w.ere noticed P2x-President
Adams, several members of Congress, and eminent medical practi-
tioners. The Lecturer seemed to make a very favorable impression
upon the audience. — National Intelligencer, Washington, D. C,
Jan. 25, 1845:

$rj= Dr. Hollick commences a new course of Lectures on the
Parental Instinct, &c, at the corner of Broadway and Grand street,
this evening. We were formerly prejudiced against Dr. H., believing
that his Lectures were calculated rather to gratify a prurient curiosity
than to impart useful knowledge. The testimony of very many of his
auditors, however, including some of the purest and wisest among
those we know, has satisfied us that we were mistaken, and we now
believe that many must be profited by his inculcations, while none
can find food therein for a vicious sensuality. — JV. Y. Tribune
May 11, 1847.

422 APPENDIX.

A Gold Medal to Doctor Hollick. — The Ladies of Dr. Hollick's
class have presented him with a beautiful Gold Medal, enclosed in a
handsome morocco case. The front of the Medal hears the following
inscription :

" Presented to Frederick Hollick, M. D.. by the Ladies who attended
his Lectures on Pysiological Science, delivered at Philadelphia, March,
1S46, as an expression of their approbation of the knowledge therein
conveyed, and as a testimonial of personal regard."

On the reverse is the Sun, and reflected by the rays of the luminary,
a scroll containing the words

" To give light to them that sit in darkness."

Phila. Spirit of the Times, March 28, 1846.

" LETTERS FROM NEW YORK, NO. 11."

****** There have been several courses of Lectures
on Anatomy, this winter, adapted to popular comprehension. I rejoice
at this ; for it has long been a cherished wish with me that a general
knowledge of the structure of our bodies, and the laws which govern
it, should extend from the scientific few into the common education of
the people. I know of nothing so well calculated to diminish vice and
vulgarity as universal and rational information on these subjects.
But the impure state of society has so perverted nature, and blinded
common sense, that intelligent women, though eagerly studying the
structure of the Earth, the attraction of the Planets, and the repro-
duction of Plants, seem ashamed to know anything of the structure of
the human Body, and of those Physiological facts most intimately con-
nected with their deepest and purest emotions, and the holiest
experience of their lives. 1 am often tempted to say, as Sir C. Grandi-
son did to the Prude — ' Wottest thou not how much t'n-delicacy there
is in thy delicacy ?'

" The only Lectures I happened to attend were those of Dr. Hollick,
which interested and edified me much. They were plain, familiar
conversations, uttered and listened to with great modesty of language,
and propriety of demeanor. The Manikin, or Artificial Anatomy, by
which he illustrated his subject, is a most wonderful machine invented
by a French Physician. Jt is made of papier mache. and represents
the human body with admirable perfection, in the shape, coloring, and
arrangement even to the minutest fibres. By the removal of wires it
can be dissected completely, so as to show the locality and functions
of the various Organs, the interior of the Heart, Lungs, &c.

"Until I examined this curious piece of mechanism, I had very faint
and imperfect ideas of the miraculous machinery of the house we live
in. I found it highly suggestive of many things to my mind." * * *

L. M. C.

(Extract from a Letter in the " Boston Courier" of Monday, June
3d, 1844, by Mrs. L. M. Child.]

APPENDIX. 423

For the Citizen.
PHYSIOLOGY AND ANATOMY.

Dr. Hollick's Lectures on Physiology and Anatomy, recently
given in this city, cannot be too highly appreciated. The aim of the
Lecturer seems to be an elevated one, and I doubt not he has in this
way accomplished, and will continue to accomplish much good. The
object is one which cannot fail to interest every person who has a
desire to become acquainted with the wonderful mechanism of the
human frame ; and is couched in such delicate terms that the feelings
of the most fastidious could not be shocked, and at the same time, care
is taken that the language be such that every individual of ordinary
ability may understand.

Dr. H. may truly be considered a benefactor of the present age, and
as such should be patronized and encouraged by the wise and good.

A Friend of Humanity.
Christian Citizen, Worcester, Mass., December 16, 1S48.

Dr. Hollick's Lectures were so popular and so well attended last
week that he has been induced to commence another course this week
in Tremont Temple, where all will have a fine opportunity to see and
to hear. The first lecture of the new course will be given to the
ladies to-morrow afternoon at half past three, and in the evening to
gentlemen at half past seven, in the large Hall of Tremont Temple.
An entirely new course will be given to the ladies. The Lecturer
has every qualification to communicate instruction in a pleasing
manner. His complete apparatus of Anatomical Models and Diagrams
aftbrds grand facilities to his auditors in understanding the subjects
upon which he treats. His sobriety, earnestness, unassuming manner,
happy use of language, distinct articulation and thorough knowledge
of his subjects make his Lectures exceedingly interesting as well as
instructive. We are glad he has taken the Tremont Temple, for he
will now be able to accommodate all his hearers. — Boston Mail,
March 6, 1343.

Dr. Hollick commences to-day his new course of lectures. At
his last lecture to ladies the hall was completely filled, and over
three hundred were, from necessity, sent away ! The disappointed
may, however, have another opportunity to-day, if they attend early ;
he begins at four o'clock. It is impossible to convey any idea of the
enthusiasm the doctor has excited among both ladies and gentlemen.
They remain around him in crowds, for hours after his lecture is over,
asking for further information, and closely examining the models, &c.
His previous reputation as an author, and as the originator of this sys-
tem of popular lectures on Physiology, has excited an intense desire
to hear him in the minds of thousands. His discourses, it must be
remembered, are not superficial, and merely entertaining, but complete
and deeply instructive. See his advertisement. Gentlemen's class
at 7%.— Boston Post, February 28, 1348.

424 APPENDIX.

Dr. Hollick's First Lecture. — "We attended Dr. Hollick's first
Lecture on the " Origin of Life," delivered at Washingtonian Hell,
Bromfield street, on Monday evening, and came away, highly gratified
both with the style and matter of the lecturer Dr. H. is a clear and
forcible speaker, and while his language is perfectly familiar and per-
spicuous, he yet approaches his subject with a delicacy and reverence
which command attention and respect. Nothing but a false and
mawkish sensibility could take offence at his discourse ; and having
critically listened to his first Lecture, and his synoptical sketch of his
course, we confess that our doubts of the propriety of their being
attended by ladies — and we had our doubts — were entirely dispelled,
and we can now appreciate the commendations bestowed by Mrs.
Child upon his course. — Boston Times, Feb. 23, 1843. i

Dr. Hollick's new series of select Physiological Lectures com.
mences to-day, and will no doubt be well attended. These Lectures
have many features peculiarly their own, by which they are distin-
guished from all others of a similar kind. They are not superficial,
nor merely entertaining, but deeply interesting and practically useful.
Not the slightest approach to levity, or impropriety, is ever seen or
heard in them, so that even the most fastidious can find no objection. —
The testimony of numerous eminent citizens, and the fact that so many
Ladies attended last week that numbers could not gain admission, ig
proof enough of this. Several have remarked that the information
they gained was above all price. The audience is always very select,
and the number is never allowed to be too great for comfort. It will
be requisite to go early, however, to find seats. Remember, the gen-
tlemen in the evening, and the ladies in the afternoon. — Boston
Chronolype, March 7, 1848.

Dr. Hollick's Lecture to the Ladies, last Friday, was listened to
with the greatest satisfaction, by an audience as large as the Hall
would contain ; in fact, two or three hundred ladies could not obtain
admission. The gentlemen's class was also as fully attended as the
Doctor's arrangements allowed, and gave equal satisfaction. Every
thing is so arranged that all can see and hear without discomfort ;
and the subject is so clearly explained, and yet in so pleasing and
proper a manner, that all are interested and instructed, without even
the most sensitive and refined delicacy being in the least offended.
The ladies have another opportunity again at four o'clock to-day, and
the gentlemen at 7£ o'clock. See advertisement. — Boston Courier,
February 28, 1848.

Dr. Hollick's Private Lectures on Marriage. — When Dr. H.
was here last winter, he delivered a series of Physiological Lectures
on the subject of Marriage, which were numerously attended and
warmly approved. Many of those who then heard them have
requested their repetition, and it will be seen by the advertisement
that they are to commence to-morrow, for gentlemen, and on Thurs-
day for ladies. Married persons will readily understand the nature of
the topics to be introduced, and will see their importance, especially
to them. The want of such information, at a timely period, is
the cause of incalculable suffering and unhappiness. — Boston Bee,
March. 20, 1949.

APPENDIX. 425

Dr. Hollick's course of lectures at "Washingtonian Hall on the
Origin of Life, commenced on Monday, and were listened to with
breathless attention till the close, when the audience, in a body,
assembled around the speaker's stand, and congratulated him upon the
excellence, novelty and utility of his discourse, and the vigor and
felicity of his explanations. The manikin used by the Dr. to illustrate
his remarks, is as large as life, and contains a fac simile of all the im-
portant machinery of the human body, and it is a treat to behold them
and listen to the accompanying observations regarding their uses and
abuses. The advance of modern science is aptly illustrated by the
declaration of Dr. H, that within the last two years there have been
discovered greater facilities for teaching medical doctrines to the
multitude than the two foregoing centuries furnished for the instruc-
tion of medical men. If then, modern days afl'ord so much additional
light, it is even culpable on the part of the community if they do not
avail themselves of knowledge so indispensible to health and hap-
piness. Dr. Hollick's remarks are unexceptionable, easily understood,
and have all the force of philosophy without the learned jargon of the
pedant.— Boston Post, March 23, 1848.

QSJ" Dr. Hollick's new series of Lectures which commence to-day
for ladies in the afternoon, and for gentlemen in the evening, will no
doubt prove a source of high gratification, and useful instruction, to
all who can attend them. We understand each lecture will be quite
complete by itself, and will embrace every topic of interest and every
fact of value, that have the slightest bearing upon the subject dis-
cussed. The Dr. has a most admirable power of condensation, and
never loses time with mere words, so that he puts more valuable
matter in one of his discourses than is ordinarily scattered over four.
The ladies' lectures are all to be of a strictly useful character, em-
bracing the causes of their various complaints, and howr to avoid
them, &c. It was remarked by many, who were there last week, that
such knowledge would prevent more disease than any medical skill
could cure, and that they scarcely knew which to admire most, the
value of the information itself, or the singularly pleasing, plain, and
delicate manner in which it was communicated. The attendance will
no doubt be large, and those who go late will probably be again dis-
appointed, as hundreds were last week.— Boston Bee, March 7, 1843.

Dr. Hollick's New Series of Lectures. — At the request of
many of our citizens Dr. H. has arranged to commence on Monday
next, a course for ladies and gentlemen together, on Physiology and
Health, and also one in the afternoons for ladies alone, illustrated
by his celebrated models, paintings, &c. The great interest and im-
portance of this subject, and the reputation of the lecturer himself,
will no doubt cause a very large attendance, but the Doctor has
properly made his arrangements so that no more will be admitted than
can be comfortably seated. These lectures will be quite a prominent
feature in next week's entertainments, and we should not be sur-
prised if the Doctor is even better patronized than he was last winter,
when hundreds could not obtain admission to hear him. — Boston
Times, November 1848.

APPENDIX.

427

WRITING DESK AND GOLD PEN PRESENTED TO DR. H. B¥ ONE
OF HIS LADY CLASSES.

Dr. Hollick — Dear Sir : The members of
your class, desiring the gratification of offering
you some testimonial of their personal regard,
and grateful appreciation of the benefits which
you are conferring upon them and their sex
generally, respectfully request your acceptance
of the accompanying writing desk.

Were it necessary, we might repeat our as-
surances that your services to humanity will be,
by us, long and gratefully remembered. The
women of this generation have reason to rejoice
that, by your efforts, a new and extensive field
of information has been opened to them, whence
they may derive treasures of knowledge, of im-
mense importance to themselves and their pos-
terity, hitherto concealed within professional
enclosures.

Wishing you health and happiness, we beg
leaye to subscribe ourselves,

Truly your Friends,
Signed on behalf of the class by, .

M. G.
O. W. B.

Phila. March 20, 1845.

428 APPENDIX.

DR. HOLLICK'S BOOKS.

Many persons not able to attend Dr. Hollick's
Lectures, and yet desirous of obtaining similar
information, have requested him to write books
suitable for their instruction ; and many of his
audience also, wishing to make their acquaintance
with these subjects more complete, and to always
have a manual of reference by them, have seconded
the request. As much as his time has allowed he
has complied with this requisition, and has pub-
lished various works of this character, including
the present one, all of which will be found adver-
tised below. The circulation of these Books has
been very great, and is daily increasing, so that
large editions of them are being constantly issued.
Like the Lectures, they have been universally
approved, both by the press and the public, although,
being the first and only one of the kind, it might
have been expected that their true aim would not at
first have been seen.

APPENDIX. 429

DR. HOLLICK'S GREAT WORK FOR MEN.

THE MALE GENERATIVE ORGANS.

IN HEALTH AND DISEASE,

FROM INFANCY TO OLD AGE.

A complete Scientific Treatise on the Anatomy and Physiology of
the Male System, with a description of the

CAUSES, SYMPTOMS AND TREATMENT

of all the Diseases and Infirmities*3*© which it is liable, adapted for
every man's own private use, and including an introductory account
of all the new discoveries concerning the Physiology of the Female
system and the process of Reproduction. With colored frontispiece,
and numerous appropriate Anatomical plates.

PRICE ONE DOLLAR.

Published by Nafis & Cornish, Pearl street, New York.

N. B. — This is not a treatise on Veneral complaints, nor does it even
speak of them, but treats solely on those difficulties to which every
man is liable, and on the preservation of the Virile power.

{&* Every Adult person ought to read this book ; the information
it contains, and the warning it gives would prevent years of misery,
and save thousands of lives, if given in time. Parents especially
should read it, to learn how to prevent the destruction of their
children.

Also the " Origin of Life," a complete Scientific and popular
Treatise on the Philosophy and Physiology of the Reproduc-
tive Functions, in Plants and Animals, with Twelve Anatomical
Plates, and all the new discoveries. Thirteenth Edition. Price
One Dollar:

430 APPENDIX.

WORSTS PUBLISHED BY BR. HOLLICK.

[For every Females' own private use !]

THE DISEASES OF WOMAN,

Their Causes and Cure familiarly explained, with Practical Hints
for their prevention and for the preservation of Female Health. By
F. Hollick, M. D. Especially designed for every Female's Private
Use.

Burgess, Stringer & Co., corner of Broadway and Ann street,
New York, and for sale hy all Booksellers. Price $1 — 300 pages,
beautifully bound, and illustrated with numerous splendid Jlnatomical
Plates.

From the New York Sunday Times.

Dr. Hollick's great work, The DisEAses of Woman, which will
be found advertised in another column, is truly a valuable production,
and well sustains the author's well-earned reputation. It is a com-
plete practical treatise on female diseases, scientific enough for a
medical man, and yet so plain that every body can understand it, and
so delicately written that even the most fastidious cannot abject to a
single passage. Much of the matter it contains is quite new in this
country, even to medical men, and of the greatest interest and import-
ance. The anatomical plates are superb, and the whole book is excel-
lently got up. Every adult female in the land should read this book ;
the information it gives would prevent an incalculable amount of dis-
ease and suffering, if possessed in time ; or it will teach the best way
to cure it when unfortunately established.

(fcS=- The price of each of the above works is One Dollar, and they
may all be purchased either of Dr. H., or the Publishers, or any of the
Booksellers in Town or Country. The Publishers will also send them
by Post to any part, on receiving the money and address.

There is no derangement whatever, affecting the Reproductive
System, in either sex, nor any thing requisite in the practice of
Midwifery, but what will be found fully explained in these works.
They form in fact a complete practical, popular, medical and obstetri-
cal Library, containing the fullest and newest information, so simpli-
fied as to be adapted for popular use, and yet so thoroughly scientific
that they will serve as Manuals for Students and Medical men.

APPENDIX. 431

OUTLINES OP ANATOMY AND PHYSIOLOGY.

BY FREDERICK HOLLICK, M. D.

This is the most complete, and at the same time most simple work
ever issued on the subject. It is illustrated in a novel manner, by a
large colored Plate of the Human Organization, which dissects by
means of separate layers, from the surface of the Mdomen down to the
Spine, showing all the Organs in their proper places, all connected
together, and many of them in sections ! the whole being colored to
life. This plate is on an entire new plan, nothing of the kind having
ever before been invented ; it is almost as complete as a model, and is
invaluable for private study, for teachers, and for Medical students.
The explanations are familiar, and divested of technicalities ; and it is
still further illustrated by separate wood-cuts throughout the work,
and a beautifully engraved portrait on Steel of the author. One
volume, quarto, bound. — Price $1. Third Edition.

Published by T. B. Peterson, No. 98 Chesnut street, Philadelphia.

Dr. Hollick's " Outlines of Jlnatomy and Physiology," for sale by
the booksellers, is an excellent publication. The dissected plate will
teach a beginner much more regarding the position, character, and
appearance of the human organs, than any work whatever, with dis-
connected illustrations. The letter press is succinct and intelligible,
and to those who, knowing nothing of anatomy and physiology, are
desirous of obtaining general information on these subjects, without
much expense, we heartily commend Dr. Hollick's " Outlines." —
Boston Post.

The Matron's Manual of Midwifery, and the Diseases
of Pregnancy and Childbirth.

This work explains the whole process of labor, and all its difficulties,
with the proper mode of assisting, in such a simple manner, but at the
same time so correctly and scientifically, that any female could, after
reading it, assist another during delivery with confidence and success.
The diseases also of pregnancy and childbed, are fully explained,
with the simplest and best mode of treating them, and also the acci-
dents to which the new born infant is liable.

This book will serve as a Manual for students and practioners, as
well as for females, and will be found to contain full information on
every point of interest connected with this great subject. No female
who values her own welfare, and who desires to be useful in cases of
emergency, will neglect to possess it. ^

It is illustrated by over Fifty splendid Plates, especially designed
for this work, and calculated to explain every part of the process.

A supplementary chapter contains a full account of the use of Ether
and Chloroform to prevent pain in labor, with numerous cases, so that
every one can judge of the value of these agents.

Published by T. W. Strong 98 Nassau street, N. Y. Price, only $1.

432 APPENDIX.

NOTICE.

Persons wishing to communicate with Dr. H.,
are requested to address to " Dr. F. Hollic'k,
New. York," and if he is not then in that city the
Letter will be forwarded to him. If advice be
requested the statement of the case must be full and
explicit, with a correct history of its origin, if that
be known, and its progress. A fee of Five Dollars
must also accompany all such Letters, or they can-
not be answered, so many being constantly received,
that the mere reading of them occupies considerable
time. If interviews be desired, or visits requested,
Dr. H. will endeavor to accommodate applicants
as far as he can, but he begs to remark that his
time is much occupied, and that such appointments
are sometimes difficult to arrange immediately.

Dr. H. is fully prepared with all the apparatus
required to practice any of the modes of treatment
described in his books, or to supply any of the
remedies therein referred to, but he thinks it
necessary to remark, that many of these from
requiring his personal supervision, and occupying
considerable time, are necessarily expensive.